NPIMap

Organization Active NPI

Preferred Vascular Services Macon LLC

  • Vascular Surgery Physician
  • Macon, GA
National Provider Identifier
1437659455
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
PREFERRED VASCULAR SERVICES MACON LLC
Practice address
889 2ND St
Macon, GA 31201-6862
Phone
(478) 254-9363
Fax
(478) 254-9362
NPI assigned
Feb 16, 2018
Last updated
Feb 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X NU
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

889 2ND St
Macon, GA 31201-6862

Mailing address

9140 Corsea del Fontana Way
Naples, FL 34109-4397

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181010003906 GA Part B Supplier - Clinic/Group Practice 6406108984 Receives reassigned benefits from 19 practitioners
Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770336000000",
    "number": "1437659455",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 2ND ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016862",
            "telephone_number": "478-254-9363",
            "fax_number": "478-254-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED VASCULAR SERVICES MACON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-16",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "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": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; 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.