SOUTH ATLANTA VASCULAR INSTITUTE, LLC
NPI 1063903078
Surgery - Vascular Surgery in Stockbridge, GA
About South Atlanta Vascular Institute, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH ATLANTA VASCULAR INSTITUTE, LLC (NPI 1063903078) is a healthcare organization registered as a vascular surgery in Stockbridge, Georgia and active in the NPI registry since May 2018. The organization holds a CLIA Certificate of Compliance certificate valid through January 20, 2027 and lists David William Allison, Managing Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Atlanta Vascular Institute, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to South Atlanta Vascular Institute, LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 11D2163934
South Atlanta Vascular Institute, LLC · Stockbridge, GAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is South Atlanta Vascular Institute, LLC's NPI number?
The NPI number for South Atlanta Vascular Institute, LLC is 1063903078. It was assigned to this organization in the NPPES registry on May 24, 2018.
Where is South Atlanta Vascular Institute, LLC located?
South Atlanta Vascular Institute, LLC is located at 4045 Mt. Zion Parkway, Stockbridge, GA 30281. The listed phone number is (770) 919-5238.
What is South Atlanta Vascular Institute, LLC's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.
Is South Atlanta Vascular Institute, LLC enrolled in Medicare?
Yes. South Atlanta Vascular Institute, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South Atlanta Vascular Institute, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to South Atlanta Vascular Institute, LLC, in Interventional Radiology, Nurse Practitioner and Vascular Surgery. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does South Atlanta Vascular Institute, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 11D2163934) is associated with this NPI, valid through January 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does South Atlanta Vascular Institute, LLC accept?
Health plans from Ambetter Health list South Atlanta Vascular Institute, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for South Atlanta Vascular Institute, LLC was last updated on September 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 59 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# South Atlanta Vascular Institute, Llc · NPI 1063903078
Vascular Surgery organization in Stockbridge, Georgia. Organization record, active in the CMS NPPES registry since May 24, 2018.
## Identity
- **NPI:** 1063903078 (Entity type: Organization)
- **Enumerated:** May 24, 2018
- **Primary specialty:** Surgery - Vascular Surgery · taxonomy 2086S0129X
- **Organization subpart:** No
- **Authorized official:** David Allison, MANAGING MEMBER
## Practice location
- **Address:** 4045 MT. ZION PARKWAY, Stockbridge, GA 30281
- **Phone:** (770) 919-5238 · **Fax:** (470) 781-5393
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Interventional Radiology (2), Vascular Surgery (2), Nurse Practitioner (1); 3 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 9, 2026
- **Other identifiers:** Medicaid 1760644355 (MA); Medicaid 1598965006 (GA); Medicaid 1386869535 (TN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063903078) · Data from the CMS NPPES public registry.