Premier Vascular Associates, PLLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

4301084691 Issued in MI

Legal business name

PREMIER VASCULAR ASSOCIATES, PLLC

Practice address

29519 Harper Ave
Saint Clair Shores, MI 48081-1275

Phone

(586) 270-5100

Fax

(586) 270-5111

NPI assigned

Sep 10, 2014

Last updated

May 18, 2015By 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

Jimmy C HaouilouNPI 1063676286

Title

Sole Member

Phone

(586) 270-5100

Specialties & licenses 1

Addresses

Locations

Practitioners 5

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.

• Jimmy Charbel Haouilou, M.D.

  • Vascular Surgery Physician
  • Roseville, MI
  • NPI 1063676286
  Authorized official Same address or phone
• Scott Bendix, MD

  • Vascular Surgery Physician
  • Farmington Hills, MI
  • NPI 1114288206
  NPD
• Anilda Gjergji, DNP, FNP, PMHNP

  • Nurse Practitioner
  • Bloomfield Hills, MI
  • NPI 1821679200
  NPD
• David Lorelli, MD

  • Vascular Surgery Physician
  • Detroit, MI
  • NPI 1710989363
  NPD
• Frederick John Jaecklein, M.D.

  • Vascular Surgery Physician
  • Memphis, TN
  • NPI 1215343553
  NPD

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431907200000",
    "number": "1972904951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29519 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811275",
            "telephone_number": "586-270-5100",
            "fax_number": "586-270-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29519 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811275",
            "telephone_number": "586-270-5100",
            "fax_number": "586-270-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER VASCULAR ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-10",
        "last_updated": "2015-05-18",
        "status": "A",
        "authorized_official_last_name": "HAOUILOU",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "586-270-5100"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301084691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur John Post, D.D.S.
• Jason Potter, SRNA
• Vance Daly Powell III, RN, BSN, NP-C
• Vasilios Pozios, MD
• Kailei Marie Prazuch
• Sarah Press, DNP, CRNA
• Preventive Cardiovascular Institute PLLC
• Lisa Ann Price, DC
• Sara Prigorac, MS OTRL
• Primary Care Associates Group PC

• Vascular Surgery Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Vascular Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.