Wayne Health Vascular and Vein Center LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

200201214 Issued in NC

Legal business name

WAYNE HEALTH VASCULAR AND VEIN CENTER LLC

Practice address

208 Cox Blvd
Suite 201
Goldsboro, NC 27534-9414

Phone

(919) 587-3333

Fax

(919) 587-3334

NPI assigned

Nov 30, 2015

Organization subpart

Yes

Parent organization

WAYNE HEALTH PHYSICIANSAs reported in NPPES

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

Authorized official

Name

Mr. Clyde Louis Thomas

Title

Executive Director

Phone

(919) 587-4081

Specialties & licenses 1

Addresses

Part of

Wayne Health Physicians

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wayne Health Physicians

  • Clinical Social Worker
  • Goldsboro, NC
  • NPI 1053661066
  NPPES parent name

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448841600000",
    "number": "1508230608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 COX BLVD",
            "address_2": "SUITE 201",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349414",
            "telephone_number": "919-587-3333",
            "fax_number": "919-587-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COX BLVD",
            "address_2": "SUITE 201",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349414",
            "telephone_number": "919-587-3333",
            "fax_number": "919-587-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE HEALTH VASCULAR AND VEIN CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAYNE HEALTH PHYSICIANS",
        "enumeration_date": "2015-11-30",
        "last_updated": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-587-4081",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "200201214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne Health Medical Clinic, LLC
• Wayne Health Physicians
• Wayne Health Physicians
• Wayne Health Surgical Associates
• Wayne Health Urological Associates LLC
• Wayne Heart & Internal Medicine Associates PA
• Wayne Imaging LLC
• Wayne Initiatives for School Health
• Wayne Initiatives for School Health
• Wayne Memorial Hospital Inc

• Vascular Surgery Physician in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Vascular Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.