NPIMap

Organization Active NPI

St Clair Vascular Associates PC

  • Vascular Surgery Physician
  • St. Clair Shores, MI
National Provider Identifier
1720167307
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
ST CLAIR VASCULAR ASSOCIATES PC
Practice address
23829 Little Mack
Suite 200
St. Clair Shores, MI 48080-1113
Phone
(586) 772-4444
Fax
(586) 772-4411
NPI assigned
Nov 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Authorized official

Name
Ms. Diane M Hall
Title
Office Administrator
Phone
(586) 772-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

23829 Little Mack
Suite 200
St. Clair Shores, MI 48080-1113

Mailing address

23829 Little Mack
Suite 200
St. Clair Shores, MI 48080-1113
Phone (586) 772-4444

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1720167307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23829 LITTLE MACK",
            "address_2": "SUITE 200",
            "city": "ST. CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801113",
            "telephone_number": "586-772-4444",
            "fax_number": "586-772-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23829 LITTLE MACK",
            "address_2": "SUITE 200",
            "city": "ST. CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801113",
            "telephone_number": "586-772-4444",
            "fax_number": "586-772-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLAIR VASCULAR ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "586-772-4444",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.