Individual provider Active NPI

Carlos Angel Saavedra, M.D.

  • Vascular Surgery Physician
  • Copley, OH
National Provider Identifier
1528148160
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
35042004 Issued in OH
Practice address
561 Queens CT
Copley, OH 44321-3053
Phone
(330) 666-8855
Fax
(330) 666-8855
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 35042004 OH Primary

Addresses

Primary practice location

561 Queens CT
Copley, OH 44321-3053

Mailing address

561 Queens CT
Copley, OH 44321-3053
Phone (330) 666-8855

Other identifiers 1

IdentifierTypeStateIssuer
0396058MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528148160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 QUEENS CT",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443213053",
            "telephone_number": "330-666-8855",
            "fax_number": "330-666-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 QUEENS CT",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443213053",
            "telephone_number": "330-666-8855",
            "fax_number": "330-666-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAAVEDRA",
        "first_name": "CARLOS",
        "middle_name": "ANGEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35042004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0396058",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Copley, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.