Decatur Vein Clinic, Michigan, PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

DECATUR VEIN CLINIC, MICHIGAN, PC

Practice address

1669 Hamilton Rd
Suite 220
Okemos, MI 48864-1956

Phone

(517) 381-1000

Fax

(517) 381-8751

NPI assigned

Aug 22, 2006

Organization subpart

No

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

Authorized official

Name

David R Decatur, MD

Title

Ceo

Phone

(317) 218-2800

Specialties & licenses 1

Addresses

Other names 1

• Decatur Vein Clinic Doing business as

Tax ID family

Decatur Vein Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Decatur Vein Clinic, Michigan, PC

  • Vascular Surgery Physician
  • Grand Rapids, MI
  • NPI 1427050046
  NPD tax ID

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679689541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4237",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460824237",
            "telephone_number": "317-218-2800",
            "fax_number": "317-818-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 HAMILTON RD",
            "address_2": "SUITE 220",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641956",
            "telephone_number": "517-381-1000",
            "fax_number": "517-381-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR VEIN CLINIC, MICHIGAN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DECATUR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-218-2800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Decatur Vein Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Micah Ebele Dawati, PA-C
• Jaime Day
• Sarah Elizabeth De Leeuw, NP-C
• Ryan Deboer, LPC
• Dana Decarteret
• Rebecca Kaye Decess, LMSW
• Sarah Elizabeth Deck Davis, DDS
• Corey Decker
• Katheryn Deforest, LLMSW
• Pauline Kay Dehlin, FNP

• Vascular Surgery Physician in Okemos, MI
• Providers in Okemos, MI by specialty
• Vascular Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.