Southwest Atlanta Vascular Care, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

SOUTHWEST ATLANTA VASCULAR CARE, LLC

Practice address

3885 Princeton Lakes Way SW
Suite 314
Atlanta, GA 30331-5589

Phone

(404) 349-7770

Fax

(404) 349-7778

NPI assigned

Mar 20, 2017

Organization subpart

No

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

Authorized official

Name

Lisa McNamara

Title

Evp

Phone

(239) 597-2010

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1861933178",
    "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": "3885 PRINCETON LAKES WAY SW",
            "address_2": "SUITE 314",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315589",
            "telephone_number": "404-349-7770",
            "fax_number": "404-349-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST ATLANTA VASCULAR CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "MCNAMARA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "239-597-2010"
    },
    "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": []
}

• Southwest Atlanta Medical & Rehabilitation Clinic LLC
• Southwest Atlanta Nephrology, PC
• Southwest Atlanta Podiatry, LLC
• Southwest Atlanta Vascular Care, LLC
• Southwest Atlanta Vascular Care, LLC
• Southwest Maxillofacial Surgery & Implant Center
• Sovereign Care Services LLC
• Sovereign Rehabilitation of Georgia, LLC
• Sovereign Rehabilitation of Georgia, LLC
• Jaconna Sowell

• Vascular Surgery Physician in Atlanta, GA
• Providers in Atlanta, 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 Mar 20, 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.