INNOVATIVE VASCULAR, PLLC
NPI 1124750765
Surgery - Vascular Surgery in Lenoir City, TN
About Innovative Vascular, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INNOVATIVE VASCULAR, PLLC (NPI 1124750765) is a healthcare organization registered as a vascular surgery in Lenoir City, Tennessee and active in the NPI registry since June 2022. The organization lists John Underwood, Vp Treasurer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Innovative Vascular, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Innovative Vascular, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Lenoir City, TN 37772
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently 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 Innovative Vascular, PLLC's NPI number?
The NPI number for Innovative Vascular, PLLC is 1124750765. It was assigned to this organization in the NPPES registry on June 30, 2022.
Where is Innovative Vascular, PLLC located?
Innovative Vascular, PLLC is located at 460 Medical Park Dr Ste 104, Lenoir City, TN 37772. The listed phone number is (865) 562-3232.
What is Innovative Vascular, PLLC's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.
Is Innovative Vascular, PLLC enrolled in Medicare?
Yes. Innovative Vascular, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Innovative Vascular, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Innovative Vascular, PLLC, in 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, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Innovative Vascular, PLLC was last updated on September 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 35 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.
# Innovative Vascular, Pllc · NPI 1124750765
Vascular Surgery organization in Lenoir City, Tennessee. Organization record, active in the CMS NPPES registry since June 30, 2022.
## Identity
- **NPI:** 1124750765 (Entity type: Organization)
- **Enumerated:** June 30, 2022
- **Primary specialty:** Surgery - Vascular Surgery · taxonomy 2086S0129X
- **Organization subpart:** No
- **Authorized official:** John Underwood, VP TREASURER
## Practice location
- **Address:** 460 MEDICAL PARK DR STE 104, Lenoir City, TN 37772-5782
- **Phone:** (865) 562-3232
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Vascular Surgery (2), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 26, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1124750765) · Data from the CMS NPPES public registry.