NPIMap

Organization Active NPI

The Vein Specialists, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bloomington, IL
National Provider Identifier
1861703100
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
036-071833 Issued in IL
Legal business name
THE VEIN SPECIALISTS, LLC
Practice address
3302 Gerig Dr
Suite 100
Bloomington, IL 61704-6365
Phone
(309) 862-4000
NPI assigned
Jul 1, 2010
Last updated
Mar 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Authorized official

Name
Dr. Kathryn Bohn, M.D.NPI 1194751156
Title
Owner
Phone
(309) 862-4000

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
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 036-071833 IL Primary

Addresses

Primary practice location

3302 Gerig Dr
Suite 100
Bloomington, IL 61704-6365

Mailing address

3302 Gerig Dr
Suite 100
Bloomington, IL 61704-6365
Phone (309) 862-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110105000921 IL Part B Supplier - Clinic/Group Practice 3870782915 Receives reassigned benefits from 6 practitioners
Practice locations: Bloomington, IL; Peru, IL

National Provider Directory

National Provider Directory

Locations

101 S Major St
#3
Eureka, IL 61530
Phone (309) 467-2371

2011 Rock St
Ste C
Peru, IL 61354
Phone (309) 862-4000

3602 Marquette Rd
Peru, IL 61354
Phone (815) 223-7400

2921 Greenbriar Dr
Springfield, IL 62704
Phone (217) 321-1987

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1861703100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 GERIG DR",
            "address_2": "SUITE 100",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046365",
            "telephone_number": "309-862-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 GERIG DR",
            "address_2": "SUITE 100",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046365",
            "telephone_number": "309-862-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VEIN SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "BOHN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-862-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036-071833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.