Organization Active NPI

USA Vein Clinics of Charleston LLC

  • Vascular Surgery Physician
  • Mt Pleasant, SC
National Provider Identifier
1740936285
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
USA VEIN CLINICS OF CHARLESTON LLC
Practice address
1280 Hospital Dr Unit 100
Mt Pleasant, SC 29464-1901
Phone
(847) 593-8460
NPI assigned
Feb 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Authorized official

Name
Michael Zhadkevich, MDNPI 1598724882
Title
Owner
Phone
(864) 680-2568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1280 Hospital Dr Unit 100
Mt Pleasant, SC 29464-1901

Mailing address

PO Box 1602
Northbrook, IL 60065-1602
Phone (847) 593-8460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221130000520 SC Part B Supplier - Clinic/Group Practice 6800264532 Receives reassigned benefits from 2 practitioners
Practice locations: Mt Pleasant, SC

National Provider Directory

National Provider Directory

Locations

4999 Carolina Forest Blvd
Myrtle Beach, SC 29579
Phone (330) 327-6485

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1740936285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1602",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600651602",
            "telephone_number": "847-593-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 HOSPITAL DR UNIT 100",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294641901",
            "telephone_number": "847-593-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA VEIN CLINICS OF CHARLESTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "ZHADKEVICH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-680-2568",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.