VCP RALEIGH, LLC (NPI# 1639310642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639310642 |
| Entity Type | Organization |
| Organization Name | VCP RALEIGH, LLC |
| Other Organization Name | VEIN CARE PAVILION OF RALEIGH |
| Practice Address |
6905 Knightdale Blvd Ste 105 Knightdale NC 27545-6504 |
| Mailing Address |
4350 Towne Centre Dr Ste 2000 Evans GA 30809-3301 |
| Practice Telephone | 9192660696 |
| Practice Fax Number | 9192660692 |
| Mailing Telephone | 7068543333 |
| Mailing Fax Number | 7063960615 |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2012-05-23 |
| Authorized Official Name | DR. STEVEN M ROTH (SOLE MEMBER/PRESIDENT) |
| Authorized Official Telephone | 7068543333 |
| 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 |
2008-01738 | NC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Vein Care Pavilion of Raleigh | Doing Business As Name - Organization |
| Street Address |
6905 KNIGHTDALE BLVD STE 105 |
| City | KNIGHTDALE |
| State | NC |
| Zip Code | 27545-6504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780096131 | Adam Luke Beck | Chiropractor | 6905 Knightdale Blvd Ste 105, Knightdale, NC 27545-6506 | 2014-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639688526 | Galberth Health | Physical Therapist | 8002 Peachtree Town Ln, Knightdale, NC 27545 | 2017-09-24 |
| 1790215390 | Edward Hoggard Jr. | Counselor | 2013 Ballston Place, Knightdale, NC 27545 | 2017-06-15 |
| 1730635970 | Tara Forsythe | Social Worker | 4006 Peachtree Town Lane, Knightdale, NC 27545 | 2016-08-28 |
| 1134504962 | Maybell Grino | Pharmacist | 7201 Us Highway 64, Knightdale, NC 27545 | 2015-07-22 |
| 1477948735 | Q1 Clinical Consultants, LLC | Community/Behavioral Health | 1408 Silver Valley Dr, Knightdale, NC 27545 | 2015-04-03 |
| 1235560772 | Shameka Latoya Davis | Counselor | 7417 Knightdale Blvd Unit 101, Knightdale, NC 27545 | 2013-12-10 |
| 1992135107 | Daniel Ross Conti | Dentist | 1001 Widewaters Parkway, Knightdale, NC 27545 | 2013-11-25 |
| 1255773644 | David D Sanjurjo | Nurse Practitioner | 7201 Us Hwy 64, Knightdale, NC 27545 | 2013-07-25 |
| 1790037133 | Dona D Mayo | Counselor | 502 Mcknight Drive, Better Communities, Knightdale, NC 27545 | 2012-10-09 |
| 1699972257 | Lindsay Horwat | Occupational Therapist | 1010 Emerald Common Drive, Apartment 205, Knightdale, NC 27545 | 2007-06-28 |
| Find all providers in zip 27545 | ||||
| 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 |
|---|---|---|---|---|
| 1831717693 | Mcleod Physician Associates II | Surgery | 690 Sunset Blvd N Ste 208, Sunset Beach, NC 28468-5332 | 2020-07-08 |
| 1053785220 | Novant Medical Group, Inc. | Surgery | 1420 Us Highway North 52, Suite B, Albermarle, NC 28001 | 2015-11-25 |
| 1962756148 | Vein Essentials, PC | Surgery | 580 Mccarthy Blvd, New Bern, NC 28562-5217 | 2012-11-09 |
| 1548544984 | Statesville Hma Medical Group, LLC | Surgery | 1703 Davie Ave, Statesville, NC 28677-3521 | 2011-10-04 |
| 1104001742 | Raleigh Vein & Laser Center Pa | Surgery | 10000 Falls of Neuse Rd., Suite 303, Raleigh, NC 27614 | 2008-01-02 |
| 1265613624 | Pinehurst Surgical Clinic Pa | Surgery | 1705b Berwick Dr, Laurinburg, NC 28352-5523 | 2007-11-14 |
| 1871791301 | Kathryn Lorann Davis | Surgery | 2001 Vail Ave Ste 320, Charlotte, NC 28207-1222 | 2007-07-05 |
| 1578656773 | Coastal Carolina Surgical Associates, P.a. | Surgery | 1411 Physicians Drive, Wilmington, NC 28401-7338 | 2006-10-02 |
| 1750499851 | Michael David Lininger | Surgery | 149 Macarthur St, Asheboro, NC 27203-5410 | 2006-08-28 |
| 1033141817 | Charlotte Minimally Invasive Surgical Associates Pllc | Surgery | 330 Billingsley Road, Suite 210, Charlotte, NC 28211 | 2006-07-06 |
| Find all providers with the same taxonomy | ||||
| City | KNIGHTDALE |
| Zip Code | 27545 |
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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.