EFFINGHAM VASCULAR CENTER, LLC (NPI# 1043773161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043773161 |
| Entity Type | Organization |
| Organization Name | EFFINGHAM VASCULAR CENTER, LLC |
| Other Organization Name | EFFINGHAM VASCULAR CENTER |
| Practice Address |
613 Towne Park Dr W Ste 204 Rincon GA 31326-5183 |
| Mailing Address |
459 Highway 119 South Attn.: Credentialing Springfield GA 31329 |
| Practice Telephone | 9128266771 |
| Practice Fax Number | 9122955605 |
| Mailing Telephone | 9127540175 |
| Mailing Fax Number | 9127542570 |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2020-04-13 |
| Authorized Official Name | DR. FRAN BAKER-WITT (CEO) |
| Authorized Official Telephone | 9127540160 |
| Authorized Official Credential | RN, MBA, LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Effingham Vascular Center | Doing Business As Name - Organization |
| Street Address |
613 TOWNE PARK DR W STE 204 |
| City | RINCON |
| State | GA |
| Zip Code | 31326-5183 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598220915 | Effingham Urology, LLC | Urology | 613 Towne Park Dr W Ste 204, Rincon, GA 31326-5183 | 2019-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437657160 | Vitality Counseling, Inc | Counselor | 135 Goshen Road Ext Ste 203, Rincon, GA 31326 | 2018-01-29 |
| 1174045322 | Katelyn Dodsworth Sundin | Dentist | 5871 Ga-21 S, Rincon, GA 31326 | 2017-07-10 |
| 1861943284 | Covenant Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 112 Goshen Commercial Park Dr., Rincon, GA 31326 | 2016-10-20 |
| 1013465681 | Aaron D. Webb | Nurse Practitioner | 423 S Columbia Avenue, Rincon, GA 31326 | 2016-09-13 |
| 1659726255 | Reagan Reese Powell | Counselor | 135 Goshen Rd Ext, Suite 203a, Rincon, GA 31326 | 2016-05-02 |
| 1982065652 | Shronda Bowman | Specialist | 1214n Columbia Ave, Unit B, Rincon, GA 31326 | 2016-03-09 |
| 1306202890 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 461 S Columbia Ave, Rincon, GA 31326 | 2016-01-13 |
| 1053628255 | Jennifer Erin Creech | Dentist | 429 S Columbia Ave, Rincon, GA 31326 | 2010-09-09 |
| 1548596737 | Rincon Medical Center | Clinic/Center | 119 Chimney Road, Rincon, GA 31326 | 2009-10-23 |
| 1770732968 | Hospital Authority of Effingham County | Clinic/Center | 110 Goshen Road, Rincon, GA 31326 | 2008-09-12 |
| Find all providers in zip 31326 | ||||
| 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 |
|---|---|---|---|---|
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1902423387 | Center for Vein Restoration Ga Corp | Surgery | 1100 Johnson Fy Rd Ne Ste 165, Atlanta, GA 30342-1795 | 2020-07-01 |
| 1487133278 | Usa Vascular Center of Decatur LLC | Surgery | 495 Winn Way Ste 230, Decatur, GA 30030-1736 | 2018-08-13 |
| 1841789914 | Milner Vein and Vascular LLC | Surgery | 5700 Hillandale Dr Ste 150, Lithonia, GA 30058 | 2018-05-04 |
| 1023517505 | Antioch Vascular Center, LLC | Surgery | 9104 Middleground Road, Suite 2, Savannah, GA 31406 | 2018-02-09 |
| 1689012205 | Daniel Joseph Badia | Surgery | 601 Professional Dr Ste A220, Lawrenceville, GA 30046-7698 | 2013-06-05 |
| 1740507425 | Christopher Ray Ramos | Surgery | 1365 Clifton Road Ne, Building A, Room A2200, Atlanta, GA 30322 | 2010-04-21 |
| 1184879678 | Rockdale Vascular and Thoracic Surgery, LLC | Surgery | 1368c Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2008-11-25 |
| 1528218393 | Vladimir Zahradnik | Surgery | 380 Hospital Dr Bldg A Ste 320, Macon, GA 31217 | 2008-09-29 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.