Vax Concierge Oh LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

VAX CONCIERGE OH LLC

Practice address

6 Louis Dr
Pepper Pike, OH 44124-4313

Phone

(773) 260-0964

NPI assigned

Mar 20, 2025

Organization subpart

No

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

Authorized official

Name

Benjamin Garden, MDNPI 1699193334

Title

MD/Owner

Phone

(773) 451-6215

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin C Garden, M.D.

  • Dermatology Physician
  • Skokie, IL
  • NPI 1699193334

  OH

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1742428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1467253070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7257 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121810",
            "telephone_number": "773-260-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 LOUIS DR",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441244313",
            "telephone_number": "773-260-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAX CONCIERGE OH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-20",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "GARDEN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "773-451-6215",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie A Ujczo, S.W.
• Amy Umpleby, LSW
• Kathryn Vajda, LSW
• Lindsay S Vance
• Jennifer L Vasquez, LSW
• Jonathan Vickery
• Nina Elise Visconti, CT
• Stefanie L Wagner, LISW
• Kristian Walker
• Victoria Wallace, LPN

• Dermatology Physician in Pepper Pike, OH
• Providers in Pepper Pike, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.