Southwest Atlanta Vascular Care, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTHWEST ATLANTA VASCULAR CARE, LLC

Practice address

3885 Princeton Lakes Way SW Ste 314
Atlanta, GA 30331-7100

Phone

(404) 349-7770

Fax

(404) 349-7770

NPI assigned

Jun 29, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Offiical

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Southwest Atlanta Vascular Care LLCCCN 11C0001491

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Preferred Vascular Services Northeast

  • Vascular Surgery Physician
  • Atlanta, GA
  • NPI 1780184218

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1295256295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 CORSEA DEL FONTANA WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341094397",
            "telephone_number": "239-597-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 PRINCETON LAKES WAY SW STE 314",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317100",
            "telephone_number": "404-349-7770",
            "fax_number": "404-349-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST ATLANTA VASCULAR CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-29",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFIICAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Atlanta Dialysis Centers LLC
• Southwest Atlanta Dialysis Centers LLC
• Southwest Atlanta Medical & Rehabilitation Clinic LLC
• Southwest Atlanta Nephrology, PC
• Southwest Atlanta Podiatry, LLC
• Southwest Atlanta Vascular Care, LLC
• Southwest Atlanta Vascular Care, LLC
• Southwest Maxillofacial Surgery & Implant Center
• Sovereign Care Services LLC
• Sovereign Rehabilitation of Georgia, LLC

• Ambulatory Surgical Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.