Vascular and Vein Institute of the South, PLLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

VASCULAR AND VEIN INSTITUTE OF THE SOUTH, PLLC

Practice address

904 Holiday Dr Ste 402
Forrest City, AR 72335-9157

Phone

(901) 390-2930

NPI assigned

Feb 15, 2023

Organization subpart

Yes

Parent organization

VASCULAR AND VEIN INSTITUTE OF THE SOUTH, PLLCAs reported in NPPES

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

Authorized official

Name

Heather Noel

Title

Credentialing Specialist

Phone

(901) 390-2930

Specialties & licenses 1

Addresses

Part of

Vascular and Vein Institute of the South PLLC

Locations

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1790482115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 W BRIERBROOK RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 HOLIDAY DR STE 402",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723359157",
            "telephone_number": "901-390-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR AND VEIN INSTITUTE OF THE SOUTH, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VASCULAR AND VEIN INSTITUTE OF THE SOUTH, PLLC",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "NOEL",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "901-390-2930"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Forrest City, AR
• Providers in Forrest City, AR by specialty
• Prosthetic/Orthotic Supplier in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.