Active NPI
Southwest Atlanta Vascular Care, LLC
- Critical Access Hospital
- Atlanta, GA
National Provider Identifier
1639766207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Access Hospital
- Legal business name
- SOUTHWEST ATLANTA VASCULAR CARE, LLC
- Practice address
- 3885 Princeton Lakes Way SW Ste 314
Atlanta, GA 30331-7100 - Phone
- (404) 349-7770
- Fax
- (404) 349-7778
- NPI assigned
- Dec 29, 2020
- Organization subpart
- Yes
- Parent organization
- SOUTHWEST ATLANTA VASCULAR CARE, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa McNamara
- Title
- Cfo
- Phone
- (239) 597-2010
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | Primary |
Addresses
Primary practice location
3885 Princeton Lakes Way SW Ste 314
Atlanta, GA 30331-7100
Mailing address
9140 Corsea del Fontana Way
Naples, FL 34109-4397
Phone (239) 597-2010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Hospital certification: CCN 110250
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- SOUTHWEST ATLANTA VASCULAR CARE
- Certification status
- Terminated Voluntary: merger or closure, May 11, 2023
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Dec 3, 2020
- Last certification
- Dec 3, 2020
- Beds
- 1
- Ownership / control type
- Private (for profit)
- Facility address
- 3885 Princeton Lakes Way SW, Suite 314
Atlanta, GA 30331
National Provider Directory
National Provider Directory- Part of
- Southwest Atlanta Vascular Care LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609200000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1609200000000",
"number": "1639766207",
"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",
"telephone_number": "239-597-2010",
"fax_number": "239-597-2313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3885 PRINCETON LAKES WAY SW STE 314",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303317100",
"telephone_number": "404-349-7770",
"fax_number": "404-349-7778"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHWEST ATLANTA VASCULAR CARE, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTHWEST ATLANTA VASCULAR CARE, LLC",
"enumeration_date": "2020-12-29",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A",
"authorized_official_last_name": "MCNAMARA",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "239-597-2010"
},
"taxonomies": [
{
"code": "282NC0060X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Critical Access",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
- Southwest Atlanta Dialysis Centers LLC
- Southwest Atlanta Medical & Rehabilitation Clinic LLC
- Southwest Atlanta Nephrology, PC
- Southwest Atlanta Podiatry, LLC
- Southwest Atlanta Vascular Care, LLC
- Southwest Atlanta Vascular Care, LLC
- Southwest Maxillofacial Surgery & Implant Center
- Sovereign Care Services LLC
- Sovereign Rehabilitation of Georgia, LLC
- Sovereign Rehabilitation of Georgia, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.