Surgery Adult Pediatric Vascular P.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

14009 Issued in NE

Legal business name

SURGERY ADULT PEDIATRIC VASCULAR P.C.

Practice address

2115 N Kansas Ave
Suite 107
Hastings, NE 68901-2615

Phone

(402) 462-2330

NPI assigned

Nov 21, 2007

Organization subpart

No

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

Authorized official

Name

Gary W Barth, MD

Title

Owner

Phone

(402) 462-5555

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1417138116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "address_2": "SUITE 107",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689020249",
            "telephone_number": "402-462-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 N KANSAS AVE",
            "address_2": "SUITE 107",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689012615",
            "telephone_number": "402-462-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY ADULT PEDIATRIC VASCULAR P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2010-04-12",
        "status": "A",
        "authorized_official_last_name": "BARTH",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-462-5555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NE",
            "license": "14009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04256",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND CHOICE",
            "identifier": "2009",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Hastings, NE
• Providers in Hastings, NE by specialty
• Surgery Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; 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.