NPIMap

Organization Active NPI

Center for Vein Restoration in, LLC

  • Vascular Surgery Physician
  • Greenwood, IN
National Provider Identifier
1629437397
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
CENTER FOR VEIN RESTORATION IN, LLC
Practice address
33 E County Line Rd Ste D
Greenwood, IN 46143-1078
Phone
(855) 830-8346
NPI assigned
Feb 23, 2016
Last updated
Jun 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Lorena Thomas
Title
Credentialing Manager
Phone
(815) 254-1761

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

33 E County Line Rd Ste D
Greenwood, IN 46143-1078

Mailing address

7474 Greenway Center Dr
Suite 1000
Greenbelt, MD 20770-3504
Phone (240) 965-3258

Other practice location 1

105 S Raceway Rd
Suite 135
Indianapolis, IN 46231-1414
Phone (855) 830-8346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160405002236 IN Part B Supplier - Clinic/Group Practice 8426356528 Receives reassigned benefits from 17 practitioners
Practice locations: Hobart, IN; Munster, IN; Marion, IN; Jeffersonville, IN; Indianapolis, IN; Greenwood, IN; Fort Wayne, IN; Evansville, IN
O20190930002710 IN DME Supplier - Physician - Vascular Surgery 8426356528 Practice locations: Greenwood, IN

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

7230 Engle Rd
Ste 320
Fort Wayne, IN 46804

33 E County Line Rd
Ste D
Greenwood, IN 46143
Phone (317) 644-6355

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1629437397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7474 GREENWAY CENTER DR",
            "address_2": "SUITE 1000",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703504",
            "telephone_number": "240-965-3258",
            "fax_number": "240-473-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 E COUNTY LINE RD STE D",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431078",
            "telephone_number": "855-830-8346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 S Raceway Rd",
            "address_2": "Suite 135",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462311414",
            "country_code": "US",
            "telephone_number": "855-830-8346",
            "fax_number": "240-473-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR VEIN RESTORATION IN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "LORENA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "815-254-1761"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.