PEACHTREE VASCULAR ASSOCIATES, P.C. (NPI# 1629130851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629130851 |
| Entity Type | Organization |
| Organization Name | PEACHTREE VASCULAR ASSOCIATES, P.C. |
| Practice Address |
550 Peachtree St Ne Suite 1085 Atlanta GA 30308-2232 |
| Mailing Address |
550 Peachtree St Ne Suite 1085 Atlanta GA 30308-2247 |
| Practice Telephone | 4046813190 |
| Practice Fax Number | 4046813193 |
| Mailing Telephone | 4046813190 |
| Mailing Fax Number | 4046813193 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2010-06-30 |
| Authorized Official Name | DR. GEORGE MICHAEL SKARDASIS (PRESIDENT) |
| Authorized Official Telephone | 4046813190 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | CHAMPUS | 253729461 | 01 |
| GA | AETNA | 578663 | 01 |
| GA | MEDICARE | GRP1615 | 01 |
| GA | HEALTH FIRST | 17-05841 | 01 |
| GA | 00053633A | 05 | |
| GA | NPI | 1013082387 | 01 |
| GA | MEDICARE RAILROAD | 020044829 | 01 |
| GA | BLUE CROSS BLUE SHIELD | 212200 | 01 |
| Street Address |
550 PEACHTREE ST NE SUITE 1085 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30308-2232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871599332 | Merry Ellen Sebelik | Otolaryngology | 550 Peachtree St Ne, Suite 1135, Atlanta, GA 30308-2212 | 2005-06-21 |
| 1275131393 | Anna Weaver | Registered Nurse | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2020-10-12 |
| 1629688320 | Shelby Elizabeth Murphy | Anesthesiologist Assistant | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2020-08-06 |
| 1508476755 | Ijeabalum Ibezue | Anesthesiologist Assistant | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2020-08-03 |
| 1376152744 | Jennifer Mcclure | Anesthesiologist Assistant | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2020-07-30 |
| 1831715234 | Ziluo Jaiah | Technician | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2020-06-22 |
| 1568088383 | Tonika J Swint | Nurse Practitioner | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2020-06-17 |
| 1780204701 | Ethan Emory Perkins | Nurse Practitioner | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2020-04-20 |
| 1851920185 | Alexandrea Hyunjee Kim | Student in an Organized Health Care Education/Training Program | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2020-04-07 |
| 1467081075 | Uyen Hong Tran | Physician Assistant | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285165 | Grace Mckinnon Cutchin | Speech-Language Pathologist | 550 Peachtree St. Ne, 9th Floor, Suite 4400, Atlanta, GA 30308 | 2020-08-10 |
| 1063033942 | Life University | Chiropractor | 1 Baltimore P1. Nw, Suite 100, Atlanta, GA 30308 | 2020-05-01 |
| 1184254591 | Jordan Cohen | Specialist | 1075 Peachtree Rd, Suite 300, Atlanta, GA 30308 | 2020-01-24 |
| 1104463819 | Gary Sydney Koech IIi | Registered Nurse | Emory Midtown- Davis Fischer Bld 3rd Floor, Rm 3245a, 550 Peachtree Street, N.e., Atlanta, GA 30308 | 2019-12-02 |
| 1639728207 | Shannon Oliver Sullivan | Counselor | 1 Baltimore Pl Nw, Suite 360, Atlanta, GA 30308 | 2019-09-06 |
| 1477110187 | Ariel Alibey | Preventive Medicine | 550 Peachtree St Ne Bldg 4th, Atlanta, GA 30308 | 2019-05-29 |
| 1972075497 | Laura Mcrae | Nurse Practitioner | Emory Center for Critical Care, 550 Peachtree Street, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-21 |
| 1265902134 | Kyle Brooks Kraft | Nurse Practitioner | 550 Peachtree Road, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-04 |
| 1396211025 | Vita Judkins | Pharmacist | 240 Renaissance Pkway Ne, Unit 116, Atlanta, GA 30308 | 2018-10-20 |
| 1407345911 | Caitlin Cundiff | Anesthesiology | 550 Peachtree St Ne Ste 3245b, Atlanta, GA 30308 | 2018-05-09 |
| Find all providers in zip 30308 | ||||
| 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 |
|---|---|---|---|---|
| 1902423387 | Center for Vein Restoration Ga Corp | Surgery | 1100 Johnson Fy Rd Ne Ste 165, Atlanta, GA 30342-1795 | 2020-07-01 |
| 1740507425 | Christopher Ray Ramos | Surgery | 1365 Clifton Road Ne, Building A, Room A2200, Atlanta, GA 30322 | 2010-04-21 |
| 1487819132 | Yazan Duwayri | Surgery | Division of Vascular Surgery Emory Clinic Bldg A, 1365 Clifton Road Ne. 3rd Floor, Atlanta, GA 30322-0001 | 2008-07-22 |
| 1033372610 | Robert S Crawford | Surgery | 5673 Peachtree Dunwoody Ste 675, Atlanta, GA 30342-1774 | 2008-07-03 |
| 1821039991 | Brooks A Whitney | Surgery | 5671 Peachtree Dunwoody Rd Ste 620, Atlanta, GA 30342-5006 | 2006-06-09 |
| 1962461426 | Frank L Ferrier | Surgery | 1100 Johnson Ferry, Ste 235, Atlanta, GA 30342 | 2006-03-22 |
| 1295723005 | James Milton Poindexter Jr. | Surgery | 1718 Peachtree St Nw, Suite 360, Atlanta, GA 30309-2452 | 2005-10-06 |
| 1326044330 | Charles B. Ross | Surgery | 95 Collier Road, Suite 5015, Atlanta, GA 30309 | 2005-06-23 |
| 1285114363 | Atlanta Vascular Surgery | Surgery | 1002 Lindbergh Dr Ne, Atlanta, GA 30324-3721 | 2018-08-17 |
| 1528497484 | Vcp 2 Atlanta PC | Surgery | 3390 Peachtree Rd Ne, Ste 425, Atlanta, GA 30326-1157 | 2013-11-01 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on PEACHTREE VASCULAR ASSOCIATES, P.C..
| 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.