Minimally Invasive Vascular, Inc

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

MINIMALLY INVASIVE VASCULAR, INC

Practice address

2720 US Highway 1 S Ste C
St Augustine, FL 32086-6301

Phone

(904) 444-0474

NPI assigned

Mar 13, 2018

Organization subpart

No

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

Authorized official

Name

Kok L Chong, MDNPI 1972681542

Title

Owner

Phone

(904) 320-0680

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Locations

Practitioners 2

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

• Kok L. Chong, MD

  • Vascular & Interventional Radiology Physician
  • Saint Augustine, FL
  • NPI 1972681542

  FL, Vascular & Interventional Radiology

  Medicare reassignment NPD Authorized official
• John-Paul Pham, MD

  • Interventional Cardiology Physician
  • Jacksonville, FL
  • NPI 1841491503

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1972006351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 US HIGHWAY 1 S STE C",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 US HIGHWAY 1 S STE C",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866301",
            "telephone_number": "904-444-0474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4225 Southpoint Pkwy S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322160975",
            "country_code": "US",
            "telephone_number": "904-320-0680",
            "fax_number": "904-320-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE VASCULAR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-13",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "CHONG",
        "authorized_official_first_name": "KOK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-320-0680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindy L Milton, LMT
• Mindful Mosaic Therapy, LLC
• Mindspace Counseling LLC
• Mindy'S Massage and Wellness, LLC
• Mindy'S Wellness Center
• Kleo Leticia Minor
• Kamlesh Minshew, LMT, E-RYT, MA, BA,
• Kelly R Minter, LMHC
• Lorrie Miot
• Christopher Chase Misso, LMT

• Vascular & Interventional Radiology Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Vascular & Interventional Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.