Georgia Vascular Institute, LLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

GEORGIA VASCULAR INSTITUTE, LLC

Practice address

3886 Princeton Lakes Way SW Ste 100
Atlanta, GA 30331-5511

Phone

(770) 506-4007

Fax

(678) 623-3543

NPI assigned

Jul 6, 2009

Last updated

Dec 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Holly Farrow

Title

Coo

Phone

(770) 506-4007

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Aic of Dawsonville, LLC

  • Radiology Clinic/Center
  • Dawsonville, GA
  • NPI 1144536996

  Member Of

  NPD member

Locations

Practitioners 4

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.

• Kevin L Carson, MD

  • Vascular & Interventional Radiology Physician
  • Atlanta, GA
  • NPI 1649257825
  Medicare reassignment NPD
• Sendhil K Subramanian, MD

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1902883168
  Medicare reassignment NPD
• Javan S. Bass, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lithonia, GA
  • NPI 1669601381
  NPD (past)
• Tommy Lee Tally, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Suwanee, GA
  • NPI 1427523919

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1912136524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3886 PRINCETON LAKES WAY SW STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315511",
            "telephone_number": "770-506-4007",
            "fax_number": "678-623-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3886 PRINCETON LAKES WAY SW STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315511",
            "telephone_number": "770-506-4007",
            "fax_number": "678-623-3543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Eagles Landing Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302815084",
            "country_code": "US",
            "telephone_number": "770-506-4007",
            "fax_number": "678-246-5191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8225 Mall Pkwy Ste 230",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "300386913",
            "country_code": "US",
            "telephone_number": "770-506-4007",
            "fax_number": "678-246-5191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEORGIA VASCULAR INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-06",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "FARROW",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-506-4007"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia Urology Pediatric LLC
• Georgia Urology Robotics
• Georgia Uvc Medical LLC (United Vein & Vascular Centers)
• Georgia Vascular Clinic at Saint Joseph's, LLC
• Georgia Vascular Clinic PA
• Georgia Vascular Specialists PC
• Georgia Wellness & Rehab Center
• Georgia Wellness Associates (Georgia Pain and Wellness)
• Georgia West Imaging, PC
• Georgia Wound Care Experts Inc

• Vascular & Interventional Radiology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Vascular & Interventional Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.