UNIVERSITY VASCULAR SPECIALIST, INC. (NPI# 1104051754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104051754 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY VASCULAR SPECIALIST, INC. |
| Practice Address |
818 Saint Sebastian Way Suite 408 Augusta GA 30901-2651 |
| Practice Telephone | 7067222334 |
| Practice Fax Number | 7067248495 |
| Mailing Telephone | 7067222334 |
| Mailing Fax Number | 7067248495 |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2009-05-27 |
| Authorized Official Name | DR. ROBERT RALPH MENDES (PARTNER) |
| Authorized Official Telephone | 7067222334 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
818 SAINT SEBASTIAN WAY SUITE 408 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30901-2651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083612352 | Randy Wilson Cooper | Surgery | 818 Saint Sebastian Way, Suite 408, Augusta, GA 30901-2651 | 2005-07-12 |
| 1144697194 | Debora Sumner Mulling | Nurse Practitioner | 818 Saint Sebastian Way, Suite 308, Augusta, GA 30901-2651 | 2015-08-25 |
| 1427483155 | Erin Timmerman Cooper | Nurse Practitioner | 818 Saint Sebastian Way, Suite 307, Augusta, GA 30901 | 2013-09-12 |
| 1588902613 | Matthew K Howard, Md, LLC | Internal Medicine | 818 Saint Sebastian Way, Suite 311, Augusta, GA 30901-2651 | 2013-01-24 |
| 1760735401 | Toni Lynn Davis | Physician Assistant | 818 Saint Sebastian Way, Suite 311, Augusta, GA 30901-2651 | 2012-10-18 |
| 1750515672 | Neighborhood Improvement Project Inc. | Legal Medicine | 818 Saint Sebastian Way, Suite 404a, Augusta, GA 30901-2651 | 2009-05-06 |
| 1407011802 | Santosh C Varkey | Internal Medicine | 818 Saint Sebastian Way, Suite 311, Augusta, GA 30901-2651 | 2008-07-24 |
| 1164685343 | University Sleep Associates | Specialist | 818 Saint Sebastian Way, Suite 101, Augusta, GA 30901-2651 | 2008-07-08 |
| 1235301771 | Brandi Nicole Pettis | Audiologist | 818 Saint Sebastian Way, Suite 204, Augusta, GA 30901-2651 | 2008-03-25 |
| 1912180134 | Beveridge Medical Associates, LLC | Neurological Surgery | 818 Saint Sebastian Way, Suite 408, Augusta, GA 30901-2651 | 2007-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019925 | Courtney Erin Fairchild | Physician Assistant | 1101 15th Street, Pa-224, Augusta, GA 30901 | 2019-02-20 |
| 1699263921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1022 Walton Way Spc C, Augusta, GA 30901 | 2018-04-23 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1457690745 | Rehab Without Walls, Inc. | In Home Supportive Care | 820 St Sebastin Way Se, Augusta, GA 30901 | 2013-02-06 |
| 1861788051 | Christina Weidner Belcher | Physical Therapist | 1246 Pine St, Augusta, GA 30901 | 2011-06-25 |
| 1750695979 | C H Martin Company | Durable Medical Equipment & Medical Supplies | 1456 Walton Way Suite B, Augusta, GA 30901 | 2010-07-29 |
| 1366773905 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4027 Wheeler Rd, Augusta, GA 30901 | 2010-01-21 |
| 1851622484 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1715 Forest Drive, Augusta, GA 30901 | 2010-01-21 |
| 1760615280 | Absolute Family PCh | Point of Service | 2035 Old Savannah Rd., Augusta, GA 30901 | 2009-09-01 |
| 1073740643 | Ryan J Altenburg | Internal Medicine | 820 Saint Sebastian Way Ste 8a, Augusta, GA 30901 | 2009-06-22 |
| Find all providers in zip 30901 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881863793 | Luis Suarez Jr. | Surgery | 2233 Richards Rd, Augusta, GA 30906-2837 | 2008-02-25 |
| 1659587269 | Charles Herman Wray | Surgery | 3115 Ramsgate Rd, Augusta, GA 30909-3323 | 2007-05-14 |
| 1386056752 | Michael N Neilson | Surgery | 35 Medical Center Pkwy, Augusta, ME 04330-8160 | 2014-05-20 |
| 1912297557 | Mrinal Shukla | Surgery | 1120 15th St # Ba-4411, Augusta, GA 30912 | 2011-04-16 |
| 1083930812 | Alison Folger Ward | Surgery | 1120 15th St, Augusta, GA 30912-0004 | 2010-04-19 |
| 1265668271 | Steven M. Roth, M.d., P.C. | Surgery | 2101 Central Ave, Augusta, GA 30904-6706 | 2009-06-04 |
| 1588829055 | Aaron Michael Hurd | Surgery | 630 13th St, Suite 250, Augusta, GA 30901-1015 | 2008-07-24 |
| 1689867897 | William S Hiltz | Surgery | 630 13th Street, Suite 250, Augusta, GA 30901-1017 | 2007-08-21 |
| 1932303815 | John Thomas Frederick | Surgery | 630 13th St, Suite 250, Augusta, GA 30901-1015 | 2007-06-13 |
| 1609096585 | Houman Tamaddon | Surgery | 1350 Walton Way, Augusta, GA 30901-2612 | 2007-04-26 |
| Find all providers in AUGUSTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.