Organization Active NPI

Central Alabama Vein & Aesthetics LLC

  • Phlebology Physician
  • Jasper, AL
National Provider Identifier
1780399832
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
CENTRAL ALABAMA VEIN & AESTHETICS LLC
Practice address
1450 Jones Dairy Rd Ste 400
Jasper, AL 35501-6109
Phone
(205) 737-0307
NPI assigned
Jan 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Dr. Michael Solomon, MDNPI 1093924391
Title
Director
Phone
(205) 737-0307

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202K00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X

Addresses

Primary practice location

1450 Jones Dairy Rd Ste 400
Jasper, AL 35501-6109

Mailing address

2100 Southbridge Pkwy Ste 650
Birmingham, AL 35209-1317
Phone (205) 737-0307

Other practice location 1

117 2nd Ave SE
Cullman, AL 35055-3511
Phone (205) 737-0307

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230313000548 AL Part B Supplier - Clinic/Group Practice 8729452834 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, AL; Jasper, AL; Cullman, AL

National Provider Directory

National Provider Directory

Locations

1450 Jones Dairy Rd
Ste 400
Jasper, AL 35501
Phone (205) 221-0562

Practitioners & affiliated clinicians

Practitioners 1

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": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1780399832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SOUTHBRIDGE PKWY STE 650",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352091317",
            "telephone_number": "205-737-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 JONES DAIRY RD STE 400",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355016109",
            "telephone_number": "205-737-0307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 2nd Ave SE",
            "address_purpose": "LOCATION",
            "city": "Cullman",
            "state": "AL",
            "postal_code": "350553511",
            "country_code": "US",
            "telephone_number": "205-737-0307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL ALABAMA VEIN & AESTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "205-737-0307",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.