Northeast Atlanta Vascular Care, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

NORTHEAST ATLANTA VASCULAR CARE, LLC

Practice address

1 Dunwoody Park Ste 130
Atlanta, GA 30338-6714

Phone

(239) 597-2010

Fax

(239) 597-2313

NPI assigned

Feb 1, 2012

Last updated

Sep 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa McNamara

Title

Cfo

Phone

(239) 597-2010

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1417229741",
    "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",
            "fax_number": "239-597-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DUNWOODY PARK STE 130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386714",
            "telephone_number": "239-597-2010",
            "fax_number": "239-597-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ATLANTA VASCULAR CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "MCNAMARA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "239-597-2010"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "northeast@pmgvascular.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Dunwoody Park Ste 130",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303386714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Northeast Atlanta Vascular Care, LLC
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• Vascular Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.