NPIMap

Organization Active NPI

Vascular Radiology Associates, II

  • Vascular & Interventional Radiology Physician
  • Augusta, GA
National Provider Identifier
1346357217
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
018827 Issued in GA
Legal business name
VASCULAR RADIOLOGY ASSOCIATES, II
Practice address
630 13TH Street
Suite 250
Augusta, GA 30901
Phone
(706) 724-2500
Fax
(706) 731-5289
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Dr. William Bruce Tannehill, M.D.NPI 1053377879
Title
Partner
Phone
(706) 667-7450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085B0100X 018827 GA
Diagnostic Neuroimaging (Radiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085D0003X 018827 GA
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0700X 018827 GA
Nuclear Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0904X 018827 GA
Pediatric Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085P0229X 018827 GA
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 018827 GA
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X 018827 GA Primary
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X 018827 GA
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 018827 GA

Addresses

Primary practice location

630 13TH Street
Suite 250
Augusta, GA 30901

Mailing address

1125 Troupe St
Augusta, GA 30904-4480
Phone (706) 667-7450

Other identifiers 1

IdentifierTypeStateIssuer
132971MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412000671 GA Part B Supplier - Clinic/Group Practice 1456345651 Receives reassigned benefits from 15 practitioners
Practice locations: Augusta, GA

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

630 13th St
Ste 250
Augusta, GA 30901
Phone (706) 724-2500

3624 J Dewey Gray Cir
Ste 100
Augusta, GA 30909
Phone (706) 561-6501

3623 J Dewey Gray Cir
Ste 100
Augusta, GA 30909
Phone (706) 651-6700

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1346357217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 TROUPE ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044480",
            "telephone_number": "706-667-7450",
            "fax_number": "706-731-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 13TH STREET",
            "address_2": "SUITE 250",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30901",
            "telephone_number": "706-724-2500",
            "fax_number": "706-731-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR RADIOLOGY ASSOCIATES, II",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "TANNEHILL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "706-667-7450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": "GA",
            "license": "018827",
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "GA",
            "license": "018827",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": "GA",
            "license": "018827",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": "GA",
            "license": "018827",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Pediatric Radiology",
            "state": "GA",
            "license": "018827",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "018827",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "018827",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "GA",
            "license": "018827",
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "GA",
            "license": "018827",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132971",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.