Southern Kentucky Vascular Clinic PLLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

SOUTHERN KENTUCKY VASCULAR CLINIC PLLC

Practice address

50 Medpark Square Dr Ste 3
Somerset, KY 42503-1708

Phone

(606) 531-4100

Fax

(606) 220-2116

NPI assigned

Jun 7, 2022

Last updated

Jul 22, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donald W. Brown, DONPI 1891794277

Title

Physician/Owner

Phone

(270) 392-9746

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FEIHCD

Practitioners 7

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.

• Donald Wayne Brown, D.O.

  • Vascular Surgery Physician
  • Somerset, KY
  • NPI 1891794277
  Medicare reassignment Care Compare group NPD Authorized official
• Stephanyie Kimberly Carter, APRN

  • Family Nurse Practitioner
  • Columbia, KY
  • NPI 1790457935
  Medicare reassignment Care Compare group NPD
• Shannon Danielle Robinson

  • Family Nurse Practitioner
  • Somerset, KY
  • NPI 1194310045
  Medicare reassignment Care Compare group NPD
• Patricio Rosa, MD

  • Vascular Surgery Physician
  • Elizabethtown, KY
  • NPI 1629055868
  Medicare reassignment Care Compare group NPD
• Diana L Williamson, APRN, FNP-C

  • Family Nurse Practitioner
  • Nancy, KY
  • NPI 1528391570
  Medicare reassignment Care Compare group NPD
• Connie Renee Boehman, FNP-C

  • Family Nurse Practitioner
  • Evansville, IN
  • NPI 1679931778

  KY

  Medicare reassignment Care Compare group NPD
• David E. Collins, MD

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1538120035

  KY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1760111553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MEDPARK SQUARE DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425031708",
            "telephone_number": "606-531-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEDPARK SQUARE DR STE 3",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425031708",
            "telephone_number": "606-531-4100",
            "fax_number": "606-220-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN KENTUCKY VASCULAR CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-07",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "270-392-9746",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeastern Medical Supply LLC
• Southern Hearing Aid, Inc.
• Southern Kentucky Eye Center PSC
• Southern Kentucky Therapy LLC
• Southern Kentucky Vascular ASC PLLC
• Southern Kentucky Vascular Procedure Center, PLLC
• Southern Travel Surgery PLLC
• Irvin Southwood, CPSS
• Timothy A Sparkman, O.D.
• Torey Sparks

• Vascular Surgery Physician in Somerset, KY
• Providers in Somerset, KY by specialty
• Vascular Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.