NPIMap

Organization Active NPI

Indiana Vascular Associates, LLC

Doing business as Lafayette Regional Vein & Laser Center

  • Phlebology Physician
  • Lafayette, IN
National Provider Identifier
1922429141
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
INDIANA VASCULAR ASSOCIATES, LLC
Doing business as
Lafayette Regional Vein & Laser Center
Practice address
3920 St Francis Way
Suite 105
Lafayette, IN 47905-4917
Phone
(765) 807-2770
Fax
(765) 807-0348
NPI assigned
Dec 16, 2013
Last updated
Dec 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Authorized official

Name
Dr. Marlin Wade Schul, MD, MBA, RVT, FACPH
Title
President
Phone
(765) 807-2770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology Physician 202K00000X IN Primary

Addresses

Primary practice location

3920 St Francis Way
Suite 105
Lafayette, IN 47905-4917

Mailing address

3920 St Francis Way
Suite 105
Lafayette, IN 47905-4917
Phone (765) 807-2770

Other identifiers 2

IdentifierTypeStateIssuer
100379350MedicaidIN
11398636OtherINCAQH

Other names 1

  • Lafayette Regional Vein & Laser Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1922429141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 ST FRANCIS WAY",
            "address_2": "SUITE 105",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054917",
            "telephone_number": "765-807-2770",
            "fax_number": "765-807-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 ST FRANCIS WAY",
            "address_2": "SUITE 105",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054917",
            "telephone_number": "765-807-2770",
            "fax_number": "765-807-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA VASCULAR ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "SCHUL",
        "authorized_official_first_name": "MARLIN",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-807-2770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MBA, RVT, FACPH"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100379350",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11398636",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lafayette Regional Vein & Laser Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.