Mayda Vascular, Inc.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

01052526A Issued in IN

Legal business name

MAYDA VASCULAR, INC.

Practice address

3611 S Reed Rd
Suite 105
Kokomo, IN 46902-3828

Phone

(765) 453-8504

Fax

(765) 453-8123

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jaro Mayda, M.D.

Title

Owner

Phone

(765) 453-8504

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1881737724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415000",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372415000",
            "telephone_number": "765-453-8504",
            "fax_number": "765-453-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S REED RD",
            "address_2": "SUITE 105",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023828",
            "telephone_number": "765-453-8504",
            "fax_number": "765-453-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYDA VASCULAR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "MAYDA",
        "authorized_official_first_name": "JARO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-453-8504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01052526A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200272550",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC0358",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacey Diane Maul, ENP, FNP
• Ronald Maus, MD
• Clay D Maxson, RN
• Brooke May, RBT
• Thomas Lee May, RPH
• Jaro Mayda II, M.D.
• Justin Mayes
• Kerry W. Mays, MD
• Melissa McBee, MS, CCC-SLP
• Heather L McCallum, OTR

• Vascular Surgery Physician in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Vascular Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.