Organization Active NPI

University Surgical Associates of Athens

Doing business as University Vascular

  • Specialist
  • Watkinsville, GA
National Provider Identifier
1861500183
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
UNIVERSITY SURGICAL ASSOCIATES OF ATHENS
Doing business as
University Vascular
Practice address
1357 Oconee Connector BLDG 300
Watkinsville, GA 30677-7314
Phone
(706) 549-8306
Fax
(706) 549-8351
NPI assigned
Aug 27, 2006
Last updated
Nov 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Authorized official

Name
Jonathan D Woody, MDNPI 1770570871
Title
Secretary
Phone
(706) 549-8306

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1357 Oconee Connector BLDG 300
Watkinsville, GA 30677-7314

Mailing address

1357 Oconee Connector
Building 300
Watkinsville, GA 30677
Phone (706) 549-8306

Other names 1

  • University Vascular Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040521000292 GA Part B Supplier - Clinic/Group Practice 2668463290 Receives reassigned benefits from 18 practitioners
Practice locations: Greensboro, GA; Watkinsville, GA
O20230525000824 GA DME Supplier - Physician - Vascular SurgeryDME Supplier - Prosthetic Personnel 2668463290 Practice locations: Watkinsville, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2038600University Surgical Vascular1357 Oconee Connector, Building 300, Watkinsville, GA 30677Certificate of waiverMar 21, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
University Surgical Associates of a1357 Oconee Connector, Watkinsville, GA 30677-73147065498306103 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses Accepts assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory

Locations

1231 Baxter St
Athens, GA 30606

195 King Ave
Athens, GA 30606
Phone (706) 543-6261

346 Deep South Farm Rd
Blairsville, GA 30512

1856 Thompson Bridge Rd
Ste 102
Gainesville, GA 30501
Phone (770) 535-1948

620 J L White Dr
Ste 140B
Jasper, GA 30143
Phone (706) 692-9016

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1861500183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 OCONEE CONNECTOR",
            "address_2": "BUILDING 300",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "30677",
            "telephone_number": "706-549-8306",
            "fax_number": "706-549-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 OCONEE CONNECTOR BLDG 300",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777314",
            "telephone_number": "706-549-8306",
            "fax_number": "706-549-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY SURGICAL ASSOCIATES OF ATHENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2023-11-15",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "WOODY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "706-549-8306",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Vascular",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.