CENTER FOR VEIN RESTORATION IN, LLC (NPI# 1629437397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629437397 |
Entity Type | Organization |
Organization Name | CENTER FOR VEIN RESTORATION IN, LLC |
Practice Address |
105 S Raceway Rd Suite 135 Indianapolis IN 46231-1414 |
Mailing Address |
7474 Greenway Center Dr Suite 1000 Greenbelt MD 20770-3504 |
Practice Telephone | 8558308346 |
Practice Fax Number | 2404734321 |
Mailing Telephone | 2409653258 |
Mailing Fax Number | 2404734321 |
Enumeration Date | 2016-02-23 |
Last Update Date | 2016-02-23 |
Authorized Official Name | KATHY JOLLEY (CREDENTIALING COORDINATOR) |
Authorized Official Telephone | 2409653258 |
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 |
105 S RACEWAY RD SUITE 135 |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46231-1414 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144712035 | Nathaniel Clark | Optometrist | 105 S Raceway Rd, Indianapolis, IN 46231-1414 | 2018-06-05 |
1982126033 | Andrea Risley | Optometrist | 105 S Raceway Rd, Indianapolis, IN 46231-1414 | 2017-07-11 |
1659668978 | Elizabeth Marie Leburg | Optometrist | 105 S Raceway Rd, Ste 100, Indianapolis, IN 46231-1414 | 2011-07-07 |
1356646574 | Decatur Vein Clinic, PC | Phlebology | 105 S Raceway Rd, Suite 135, Indianapolis, IN 46231-1414 | 2011-01-19 |
1952536518 | John Purdue Weida | Dentist | 105 S Raceway Rd, Suite 140, Indianapolis, IN 46231-1414 | 2009-05-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922594316 | Myeyedr Optometry of Indiana, LLC | Optometrist | 105 S Raceway Rd Ste 100, Indianapolis, IN 46231 | 2018-07-09 |
1740484831 | Willie Flowers | Counselor | 1933 Southwood Drive, Indianapolis, IN 46231 | 2007-06-12 |
1407068083 | Lula Coates | Social Worker | 10903 Miller Drive, Indianapolis, IN 46231 | 2007-05-04 |
1528197076 | Sitaram Investments, LLC | Dentist | 105 South Raceway Road, Suite 140, Indianapolis, IN 46231 | 2007-03-02 |
1932264744 | Julia Nolte | Optometrist | 77 S. Girl School Rd., 103, Indianapolis, IN 46231 | 2006-12-22 |
1790926764 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 8201 W Washington St, Indianapolis, IN 46231 | 2009-03-20 |
1093360984 | Glasswater Creek of Plainfield, LLC | Assisted Living Facility | 10480 Glasswater Rd, Indianapolis, IN 46231-0001 | 2019-08-07 |
1952812307 | Avon Trust Care, Inc. | Non-emergency Medical Transport (VAN) | 10608 Cyrus Dr, Indianapolis, IN 46231-1023 | 2017-10-12 |
1366965014 | Nwamaka Theresa Onochie | Counselor | 10634 Cyrus Dr, Indianapolis, IN 46231-1023 | 2017-07-24 |
1679183685 | S&n Home Care, LLC | Home Health | 10634 Cyrus Dr, Indianapolis, IN 46231-1023 | 2020-08-04 |
Find all providers in zip 46231 |
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 |
---|---|---|---|---|
1194041764 | Andrew Alexander Gonzalez | Surgery | 1801 N Senate Blvd Ste 3500, Indianapolis, IN 46202-1184 | 2010-04-08 |
1487761607 | Abdolaziz M Ardalan | Surgery | 9737 Decatur Dr, Indianapolis, IN 46256-9656 | 2006-08-24 |
1073542346 | Deepak Guttikonda | Surgery | 8075 N Shadeland Ave Ste 330, Indianapolis, IN 46250-2694 | 2006-06-30 |
1255397246 | Gary W Lemmon | Surgery | 1801 N Senate Blvd Ste D-3500, Indianapolis, IN 46202-1228 | 2006-04-26 |
1861999401 | Michael David Ingram | Surgery | 1130 W. Michigan St, Fessler Hall 318, Indianapolis, IN 46202 | 2018-04-10 |
1851746465 | Justin Rossel King | Surgery | 1801 N Senate Blvd, Mpc 2, Suite #3500, Indianapolis, IN 46202 | 2016-05-02 |
1578944427 | Sarah Strot | Surgery | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2015-06-17 |
1508285784 | Shihuan Keisin Wang | Surgery | 545 Barnhill Dr, Indianapolis, IN 46202-5112 | 2014-04-15 |
1659676146 | Gregory George Westin | Surgery | 1801 N Senate Blvd, Mpc2, Suite 3500, Indianapolis, IN 46202-1184 | 2011-01-14 |
1407014426 | Kevin M Sheridan | Surgery | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2008-05-27 |
Find all providers in INDIANAPOLIS |
City | INDIANAPOLIS |
Zip Code | 46231 |
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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.