VCP Atlanta, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

48566 Issued in GA

Legal business name

VCP ATLANTA, LLC

Doing business as

Vein Care Pavilion of Atlanta

Practice address

3390 Peachtree Rd NE
Ste 425
Atlanta, GA 30326-1157

Phone

(404) 846-2460

Fax

(404) 846-2440

NPI assigned

Oct 14, 2009

Organization subpart

No

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

Authorized official

Name

Steven M Roth, MD

Title

Sole Member/President

Phone

(706) 854-2138

Specialties & licenses 2

Addresses

Other names 1

• Vein Care Pavilion of Atlanta Doing business as

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1437484185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR",
            "address_2": "STE 2000",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093301",
            "telephone_number": "706-854-3333",
            "fax_number": "706-396-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE RD NE",
            "address_2": "STE 425",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261157",
            "telephone_number": "404-846-2460",
            "fax_number": "404-846-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VCP ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-14",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MEMBER/PRESIDENT",
        "authorized_official_telephone_number": "706-854-2138",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "033061",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "48566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vein Care Pavilion of Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Vazquez, M.D.
• Kimberly Crystle Vazquez, O.D.
• Valeria Vazquez
• VBDC of Woodstock, LLC
• VCP 2 Atlanta PC
• VDS Surgical Assistants, Inc.
• Brian David Veal, DC
• Detavius Veal
• Lindsey Veal Jr., LPC
• Vicky W. Veal, CRNA

• 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 May 23, 2012; 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.