NPIMap

Organization Active NPI

Truffles Vein of Central Georgia LLC

  • Vascular Specialist/Technologist Cardiovascular
  • Powder Springs, GA
National Provider Identifier
1457100430
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Specialist/Technologist CardiovascularTaxonomy code 246XC2903X
Legal business name
TRUFFLES VEIN OF CENTRAL GEORGIA LLC
Practice address
5041 Dallas Hwy Ste E
Powder Springs, GA 30127-6458
Phone
(678) 833-1444
NPI assigned
May 14, 2024
Last updated
May 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Paul D Feldman, MDNPI 1588656367
Title
President
Phone
(678) 833-1444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Specialist/Technologist Cardiovascular 246XC2903X NU Primary

Addresses

Primary practice location

5041 Dallas Hwy Ste E
Powder Springs, GA 30127-6458

Mailing address

874 Lanier Ave W Ste 220
Fayetteville, GA 30214-7659
Phone (678) 833-1444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241212000244 GA Part B Supplier - Clinic/Group Practice 8527594662 Receives reassigned benefits from 12 practitioners
Practice locations: Powder Springs, GA; Newnan, GA; Fayetteville, GA; Carrollton, GA; McDonough, GA

National Provider Directory

National Provider Directory

Locations

8 E Court Sq
Newnan, GA 30263
Phone (678) 833-1444

5041 Dallas Hwy
Ste 107
Powder Springs, GA 30127
Phone (678) 833-1444

5041 Dallas Hwy
Ste E
Powder Springs, GA 30127
Phone (678) 833-1444

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1457100430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 LANIER AVE W STE 220",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147659",
            "telephone_number": "678-833-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 DALLAS HWY STE E",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301276458",
            "telephone_number": "678-833-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUFFLES VEIN OF CENTRAL GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "FELDMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-833-1444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "246XC2903X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Vascular Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powder Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.