NPIMap

Organization Active NPI

Fresenius Vascular Care Pensacola LLC

  • Vascular & Interventional Radiology Physician
  • Crestview, FL
National Provider Identifier
1760151682
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
FRESENIUS VASCULAR CARE PENSACOLA LLC
Practice address
221 E Redstone Ave
Crestview, FL 32539-5373
Phone
(850) 398-6606
NPI assigned
Sep 13, 2021
Organization subpart
Yes
Parent organization
FRESENIUS VASCULAR CARE PENSACOLA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Authorized official

Name
Gregg Arthur Miller, MD
Title
Sr. Vice President
Phone
(610) 644-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

221 E Redstone Ave
Crestview, FL 32539-5373

Mailing address

PO Box 419076
Boston, MA 02241-9076
Phone (610) 644-8900

National Provider Directory

National Provider Directory
Tax ID family
Fresenius Vascular Care Pensacola LLC3 organizations share this tax ID, including this one
Part of
Fresenius Vascular Care Pensacola LLC

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631491200000",
    "number": "1760151682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419076",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022419076",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E REDSTONE AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395373",
            "telephone_number": "850-398-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS VASCULAR CARE PENSACOLA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS VASCULAR CARE PENSACOLA LLC",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT",
        "authorized_official_telephone_number": "610-644-8900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.