Costal Georgia Vein Center Inc.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

COSTAL GEORGIA VEIN CENTER INC.

Practice address

2444 Parkwood Dr
Brunswick, GA 31520-4721

Phone

(912) 267-9550

Fax

(912) 264-5128

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Gregory D Martin, M.D.NPI 1194782771

Title

President

Phone

(912) 267-9550

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory D Martin, MD

  • Surgery Physician
  • Valdosta, GA
  • NPI 1194782771
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1932218617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2444 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204721",
            "telephone_number": "912-267-9550",
            "fax_number": "912-264-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 PARKWOOD DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204721",
            "telephone_number": "912-267-9550",
            "fax_number": "912-264-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTAL GEORGIA VEIN CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-267-9550",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Thurman Cooper, M.D.
• Michael Townsend Cooper Jr., M.D.
• Cooperative Healthcare Services Inc
• Cooperative Healthcare Services, Inc.
• Cooperative Rehab Services, LLC
• Costrini & Meadows PC
• Maria C Coughenour, LPC
• Steven Forrest Cowan, LPC
• Eleanor Cowherd, APRN
• Helene Victoria Coyle, MD

• Vascular Surgery Physician in Brunswick, GA
• Providers in Brunswick, 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 Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.