South Georgia Vein Centers LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

SOUTH GEORGIA VEIN CENTERS LLC

Practice address

3338 Country Club Rd # M
Valdosta, GA 31605-1044

Phone

(229) 259-9666

Fax

(229) 253-0064

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Gregory D Martin, M.D.NPI 1194782771

Title

President

Phone

(229) 259-9666

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• Gregory D Martin, MD

  • Surgery Physician
  • Valdosta, GA
  • NPI 1194782771
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1669405452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3338 L1 COUNTRY CLUB RD PMB 342",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31605",
            "telephone_number": "229-259-9666",
            "fax_number": "229-253-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3338 COUNTRY CLUB RD # M",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316051044",
            "telephone_number": "229-259-9666",
            "fax_number": "229-253-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA VEIN CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-259-9666",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Georgia Psychiatric & Counseling Center
• South Georgia Regional Anesthesia, PC
• South Georgia Toxicology, Inc
• South Georgia Transitional Living Center (Distinct Minds Academy)
• South Georgia Upper Cervical Chiropractic, LLC (South Georgia Upper Cervical Chiropractic)
• South Health District (South Health District FP)
• South Health District (Lowndes Co Board of Health - Teen Center)
• South Health District (South Health District CMS)
• South Health District (Lowndes County Board of Health)
• South Health District

• Vascular Surgery Physician in Valdosta, GA
• Providers in Valdosta, 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 Oct 7, 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.