Northeast Georgia Vascular Center

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

61114 Issued in GA

Legal business name

NORTHEAST GEORGIA VASCULAR CENTER

Doing business as

Vascular Clinics of Northeast Georgia

Practice address

4763 Shirley Rd
Gainesville, GA 30506-5108

Phone

(770) 535-1948

Fax

(770) 535-1488

NPI assigned

Oct 23, 2012

Last updated

Feb 18, 2013By 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

Michael H Lebow, M.D.

Title

Owner

Phone

(770) 535-1948

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vascular Clinics of Northeast Georgia Doing business as

Locations

Practitioners 1

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.

• Lisa Bartlow

  • Surgical Physician Assistant
  • Athens, GA
  • NPI 1053776732
  NPD (past)

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361145600000",
    "number": "1942553359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4763 SHIRLEY RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305065108",
            "telephone_number": "770-535-1948",
            "fax_number": "770-535-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4763 SHIRLEY RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305065108",
            "telephone_number": "770-535-1948",
            "fax_number": "770-535-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA VASCULAR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2013-02-18",
        "status": "A",
        "authorized_official_last_name": "LEBOW",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-535-1948",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "61114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1942553359",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vascular Clinics of Northeast Georgia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Northeast Georgia Speech Center, Inc.
• Northeast Georgia Surgery Center
• Northeast Georgia Surgical Associates PC
• Northeast Georgia Urological Assoc., P.C.
• Northeast Georgia Urological Surgery Center, LLC
• Northland Hearing Centers, Inc
• Northside Hospital, Inc. (Diagnostic Clinic Oncology Pharmacy)
• Northside Hospital, Inc. (Diagnostic Clinic Pharmacy)
• Northwest Diagnostic Imaging, Inc (Open MRI & Imaging of NE Georgia, LLC)
• Bethany Rennaye Norwood, FNP-C

• Preferred Provider Organization in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Preferred Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.