VCP Raleigh, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

2008-01738 Issued in NC

Legal business name

VCP RALEIGH, LLC

Doing business as

Vein Care Pavilion of Raleigh

Practice address

6905 Knightdale Blvd Ste 105
Knightdale, NC 27545-6504

Phone

(919) 266-0696

Fax

(919) 266-0692

NPI assigned

Mar 20, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Steven M Roth, M.D,

Title

Sole Member/President

Phone

(706) 854-3333

Specialties & licenses 1

Addresses

Other names 1

• Vein Care Pavilion of Raleigh Doing business as

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1639310642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR",
            "address_2": "STE 2000",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093301",
            "telephone_number": "706-854-3333",
            "fax_number": "706-396-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 KNIGHTDALE BLVD STE 105",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456504",
            "telephone_number": "919-266-0696",
            "fax_number": "919-266-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VCP RALEIGH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-20",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MEMBER/PRESIDENT",
        "authorized_official_telephone_number": "706-854-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2008-01738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vein Care Pavilion of Raleigh",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vascular Surgery Physician in Knightdale, NC
• Providers in Knightdale, 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 May 23, 2012; 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.