Southpark Vascular Center

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

SOUTHPARK VASCULAR CENTER

Practice address

445 Charles H Dimmock Pkwy Ste 101
Colonial Heights, VA 23834-2990

Phone

(804) 520-1764

Fax

(866) 781-3220

NPI assigned

Nov 5, 2019

Organization subpart

No

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

Authorized official

Name

Janet Dees

Title

President

Phone

(727) 214-0462

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 5

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

• Mitesh S Amin, MD

  • Cardiovascular Disease Physician
  • Colonial Heights, VA
  • NPI 1801003157

  Cardiovascular Disease, VA

  Medicare reassignment NPD
• Paul Reha Butros, MD

  • Diagnostic Radiology Physician
  • Warrenton, VA
  • NPI 1316142029

  VA

  Medicare reassignment NPD
• Tiffany Eileen Raikes, FNP-C

  • Family Nurse Practitioner
  • Colonial Heights, VA
  • NPI 1861124588

  VA

  Medicare reassignment NPD
• George Eromosele Eigbire, M.D.

  • Interventional Cardiology Physician
  • Springfield, IL
  • NPI 1093165367

  Cardiovascular Disease, VA

  Medicare reassignment NPD
• Jaspreet Singh, MD

  • Cardiovascular Disease Physician
  • Colonial Heights, VA
  • NPI 1942495312

  VA

  Medicare reassignment

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1962046763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 PALM HARBOR BLVD STE A",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831930",
            "telephone_number": "727-214-0462",
            "fax_number": "727-474-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CHARLES H DIMMOCK PKWY STE 101",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342990",
            "telephone_number": "804-520-1764",
            "fax_number": "866-781-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHPARK VASCULAR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "DEES",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-214-0462"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Solomon M Lee DDS PC
• Thomas Edward Sontag, D.C., B.S.
• Vineeta Sood, MD
• Southern Touch Health Care Services, Inc.
• Southpark Heart & Rhythm Center LLC
• Southside Endodontics, PC
• Southside Family and Cosmetic Dentistry
• Southside Head N Neck Surgery Professional Corp
• Southside Pediatric Center
• Southside Physician Network LLC

• All providers in Colonial Heights, VA
• Interventional Cardiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.