Peachtree Vascular Specialists, P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PEACHTREE VASCULAR SPECIALISTS, P.C.

Practice address

2817 Reilly St
Fort Bragg, NC 28310-6118

Phone

(910) 907-1035

Fax

(910) 907-9468

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Daniel T. McDevitt, M.D.

Title

President

Phone

(770) 996-9945

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 2

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

• Alan Merrill Levy, M.D.

  • Vascular Surgery Physician
  • Stockbridge, GA
  • NPI 1558414276
  NPD
• Mark J. Kulbaski, MD

  • Vascular Surgery Physician
  • Brockton, MA
  • NPI 1699756247
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1366595068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 SOUTHCREST DR",
            "address_2": "SUITE 250",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816118",
            "telephone_number": "770-996-9945",
            "fax_number": "770-996-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283106118",
            "telephone_number": "910-907-1035",
            "fax_number": "910-907-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE VASCULAR SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "MCDEVITT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-996-9945",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "teresa.p.hollowell.civ@mail.mil",
            "affiliation": "N",
            "endpointDescription": "Womack Army Medical Center email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "2817 Reilly St",
            "city": "Fort Bragg",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283107394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Benjamin Paul, LCSW
• Courtney J Paul, PHARM. D.
• Sally Jo Paul, OTR
• Duane Kent Paulus, PA-C
• Grace Payne, MS, RD
• Evelyn R. Pearce, PA-C
• Seth T Peavler, DO
• Michelle Pecko, PT, DPT
• Robert M Peden III, CRNA
• Brenda Pedraza, PSY.D

• Primary Care Clinic/Center in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.