VARICOSITY LLC (NPI# 1114968575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114968575 |
| Entity Type | Organization |
| Organization Name | VARICOSITY LLC |
| Practice Address |
2704 20th St S Suite 410 Birmingham AL 35209-1924 |
| Practice Telephone | 2055921800 |
| Practice Fax Number | 2055921752 |
| Mailing Telephone | 2055921800 |
| Mailing Fax Number | 2055921752 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2015-07-29 |
| NPI Deactivation Date | 08/21/2007 |
| NPI Reactivation Date | 2009-11-12 |
| Authorized Official Name | DR. CARLTON DUANE RANDLEMAN JR. (PRESIDENT) |
| Authorized Official Telephone | 2055921800 |
| Authorized Official Credential | MD |
| 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 |
2704 20TH ST S SUITE 410 |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35209-1924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487693982 | Carlton Duane Randleman Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2704 20th St S, Ste 100, Birmingham, AL 35209-1924 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793510 | Marissa M Mcintyre | Registered Nurse | 3401 Independence Drive, Suite 221, Birmingham, AL 35209 | 2019-11-01 |
| 1093284457 | Patriot Healthcare of Alabama, LLC | Family Medicine | 2045 Brookwood Medical Center Drive, Suite 1, Birmingham, AL 35209 | 2018-11-15 |
| 1164902268 | Lucy Johnston | Physician Assistant | 1602 Woodfern Dr, Homewood, AL 35209 | 2018-08-17 |
| 1881184646 | Wade Louis Grady | Specialist/Technologist | 800 Larkshore Drive, Birmingham, AL 35209 | 2018-05-16 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1396251542 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 120 Oxmoor Blvd Ste 100, Birmingham, AL 35209 | 2017-12-26 |
| 1376060954 | Hannah Holloway | Specialist/Technologist | 725 Crest Lane, Birmingham, AL 35209 | 2017-08-24 |
| 1558887463 | Paul A Rhodes | Nurse Practitioner | 631 Beacon Center Office Park, Suite 108, Birmingham, AL 35209 | 2017-08-22 |
| 1538542196 | Proteus Molecular and Clinical Lab LLC | Clinical Medical Laboratory | 218 Summit Pkwy, Suite 250, Homewood, AL 35209 | 2015-07-01 |
| 1124407739 | Randall Alban | Nurse Practitioner | 2100 Southbridge Parkway, Suite 650, Birmingham, AL 35209 | 2015-05-28 |
| Find all providers in zip 35209 | ||||
| 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 |
|---|---|---|---|---|
| 1700048998 | Barry L. Fields | Surgery | 4700 Southlake Pkwy, Birmingham, AL 35244-3202 | 2008-06-28 |
| 1548242563 | Michael A Drummond | Surgery | 817 Princeton Ave Sw, Suite 306, Birmingham, AL 35211-1333 | 2005-11-16 |
| 1467434498 | Robert Scott Mccord | Surgery | 817 Princeton Avenue Sw, Suite 306, Birmingham, AL 35211 | 2005-11-16 |
| 1457355737 | Gregory Paul Derderian | Surgery | 538 N Old Woodward Ave, Birmingham, MI 48009-5375 | 2005-06-02 |
| 1518220003 | Danielle Christine Sutzko | Surgery | 1808 7th Ave S, Birmingham, AL 35233-1912 | 2012-06-19 |
| 1316235278 | The Vein Center | Surgery | 833 Princeton Ave Sw, Pob IIi, Birmingham, AL 35211-1323 | 2011-07-13 |
| 1144510959 | Graeme Edward Brown Mcfarland | Surgery | 619 19th St S, Birmingham, AL 35249 | 2011-04-13 |
| 1114243003 | Emily Louise Spangler | Surgery | 1808 7th Ave S, Birmingham, AL 35294-1000 | 2010-04-16 |
| 1265603724 | Vascular Institute of Birmingham, PC | Surgery | 2660 10th Ave S, Pob 1, Suite 608, Birmingham, AL 35205-1605 | 2008-03-12 |
| 1932308699 | Benjamin Pearce | Surgery | 619 19th St S, Birmingham, AL 35249-1900 | 2007-07-13 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35209 |
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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.