Organization Active NPI

Thorvasc PA

  • Vascular Surgery Physician
  • Tallahassee, FL
National Provider Identifier
1831589803
Registry record updated May 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
THORVASC PA
Practice address
2623 Centennial Blvd
Suite 102
Tallahassee, FL 32308-0585
Phone
(850) 792-4722
Fax
(850) 792-4727
NPI assigned
Jan 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2017

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

Authorized official

Name
Dr. Moses Desmond Degraft-Johnson, MD
Title
Owner
Phone
(305) 301-8283

Specialties & licenses 1

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

Addresses

Primary practice location

2623 Centennial Blvd
Suite 102
Tallahassee, FL 32308-0585

Mailing address

400 Capital Cir SE
Ste 18148
Tallahassee, FL 32301-3802
Phone (850) 792-4722

National Provider Directory

National Provider Directory

Locations

400 Capital Cir SE
#18148
Tallahassee, FL 32301

400 Capital Cir SE
Ste 18148
Tallahassee, FL 32301

2623 Centennial Blvd
Ste 102
Tallahassee, FL 32308
Phone (850) 531-8346

Practitioners & affiliated clinicians

Practitioners 2

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": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495065600000",
    "number": "1831589803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CAPITAL CIR SE",
            "address_2": "STE 18148",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323013802",
            "telephone_number": "850-792-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 CENTENNIAL BLVD",
            "address_2": "SUITE 102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080585",
            "telephone_number": "850-792-4722",
            "fax_number": "850-792-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THORVASC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2017-05-18",
        "status": "A",
        "authorized_official_last_name": "DEGRAFT-JOHNSON",
        "authorized_official_first_name": "MOSES",
        "authorized_official_middle_name": "DESMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-301-8283",
        "authorized_official_name_prefix": "Dr.",
        "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 Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2017; 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.