Preferred Vascular Services Northwest, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

PREFERRED VASCULAR SERVICES NORTHWEST, LLC

Practice address

711 Canton Rd NE Ste 220
Marietta, GA 30060-8949

Phone

(404) 554-2196

Fax

(404) 597-2313

NPI assigned

Feb 1, 2012

Last updated

Feb 6, 2026By the provider in NPPES

Organization subpart

No

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

Addresses

Other names 1

• Preferred Vascular Services of Georgia, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Member of 1

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

• Preferred Vascular Services Northeast

  • Vascular Surgery Physician
  • Atlanta, GA
  • NPI 1780184218

  Member Of

  NPD member

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Macon Vascular Care, LLC

  • Vascular Surgery Physician
  • Macon, GA
  • NPI 1417381781

  Member Of

  NPD member

Locations

Practitioners 20

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.

• Aakash Amin, M.D.

  • Nephrology Physician
  • Lawrenceville, GA
  • NPI 1871668343
  Medicare reassignment Care Compare group NPD
• Demetrious J. Blackmon, M.D.

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1578592994
  Medicare reassignment Care Compare group NPD
• Carl Gonzales II, M.D.

  • Vascular Surgery Physician
  • Conyers, GA
  • NPI 1356668487
  Medicare reassignment Care Compare group NPD
• Jalal Eddin Hakmei, M.D.

  • Nephrology Physician
  • Marietta, GA
  • NPI 1730468570
  Medicare reassignment Care Compare group NPD
• Samuel Andrew Johnson, MD

  • Nephrology Physician
  • Marietta, GA
  • NPI 1225255128
  Medicare reassignment Care Compare group NPD
• John Theodore Perry III, M.D.

  • Vascular Surgery Physician
  • Marietta, GA
  • NPI 1578644258
  Medicare reassignment Care Compare group NPD
• Shrenik Pankaj Shah, M.D.

  • Vascular & Interventional Radiology Physician
  • Atlanta, GA
  • NPI 1114168846
  Medicare reassignment Care Compare group NPD
• Mohammed Salman Singapuri, MD

  • Nephrology Physician
  • Decatur, GA
  • NPI 1619195732
  Medicare reassignment Care Compare group NPD
• Shoaib Muhammad Wazir, M.D

  • Nephrology Physician
  • Acworth, GA
  • NPI 1407297823
  Medicare reassignment Care Compare group NPD
• Sandeep B Sharma, MD

  • Nephrology Physician
  • Pittsburgh, PA
  • NPI 1447206743

  GA

  Medicare reassignment Care Compare group NPD
• Felicity A Devaughn, PA-C

  • Medical Physician Assistant
  • Powder Springs, GA
  • NPI 1568593788
  Medicare reassignment Care Compare group
• Victor C Njoku, M.D.

  • Vascular Surgery Physician
  • Griffin, GA
  • NPI 1447489026
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770336000000",
    "number": "1598037822",
    "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": "711 CANTON RD NE STE 220",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608949",
            "telephone_number": "404-554-2196",
            "fax_number": "404-597-2313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 S 8th St",
            "address_purpose": "LOCATION",
            "city": "Griffin",
            "state": "GA",
            "postal_code": "302244213",
            "country_code": "US",
            "telephone_number": "404-554-2196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5461 Hillandale Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "300584842",
            "country_code": "US",
            "telephone_number": "770-981-8477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3885 Princeton Lakes Way SW Ste 314",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303317100",
            "country_code": "US",
            "telephone_number": "404-349-7770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "889 2nd St",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312016862",
            "country_code": "US",
            "telephone_number": "478-254-9363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "960 Joe Frank Harris Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Cartersville",
            "state": "GA",
            "postal_code": "301202129",
            "country_code": "US",
            "telephone_number": "404-554-2196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 Canton Rd NE Ste 230",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300608949",
            "country_code": "US",
            "telephone_number": "404-554-2196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREFERRED VASCULAR SERVICES NORTHWEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preferred Vascular Services of Georgia, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Vascular Surgery Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Vascular Surgery Physician in Georgia

• 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.