Northwest Atlanta Vascular Care LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

NORTHWEST ATLANTA VASCULAR CARE LLC

Practice address

711 Canton Rd NE Ste 220
Marietta, GA 30060-8949

Phone

(239) 597-2010

Fax

(239) 597-2313

NPI assigned

Feb 26, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa A McNamara

Title

Evp

Phone

(239) 597-2010

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1330214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1861766636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 CORSEA DEL FONTANA WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341094397",
            "telephone_number": "239-597-2010",
            "fax_number": "239-597-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 CANTON RD NE STE 220",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608949",
            "telephone_number": "239-597-2010",
            "fax_number": "239-597-2313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 Church St NE",
            "address_2": "Suite 510",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300607282",
            "country_code": "US",
            "telephone_number": "404-403-8310",
            "fax_number": "888-373-0497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHWEST ATLANTA VASCULAR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-26",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "MCNAMARA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "239-597-2010",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northwest ENT Associates, PC
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• Vascular Surgery Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.