MACON VASCULAR CARE, LLC
NPI 1417381781
Surgery - Vascular Surgery in Macon, GA
NPI Status: Active since August 22, 2013
- Organization
- Surgery
- Vascular Surgery
- CLIA Number: 11D2065958
- CLIA Cert. Type: Other - EXT OF PHYSICIAN OFFICE
- CLIA Exp. Date: 09-17-2027
About MACON VASCULAR CARE, LLC
This page provides the complete NPI Profile along with additional information for Macon Vascular Care, Llc, a provider established in Macon, Georgia operating as a Surgery, focusing in vascular surgery . The healthcare provider is registered in the NPI registry with number 1417381781 assigned on August 2013. The practitioner's primary taxonomy code is 2086S0129X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Lisa A Mcnamara (Executive Vice President)
- NPI
- 1417381781
- Provider Name
- MACON VASCULAR CARE, LLC
- Entity Type
- Organization
- Location Address
- 889 2ND ST MACON, GA 31201
- Location Phone
- (478) 254-9363
- Mailing Address
- 9140 CORSEA DEL FONTANA WAY NAPLES, FL 34109
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-22-2013
- Last Update Date
- 08-22-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery Vascular Surgery
- Taxonomy Code
- 2086S0129X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2065958
- Facility Type
- Other - EXT OF PHYSICIAN OFFICE
- Certificate Effective Date
- September 18, 2025
- Certificate Expiration Date
- September 17, 2027
- Laboratory Director
- DR. DEMETRIOUS BLACKMON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Macon Vascular Care, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1417381781, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417381781, enumerated as an "organization" on August 22, 2013.
The provider is located at 889 2ND ST MACON, GA 31201 and the phone number is (478) 254-9363.
Surgery with taxonomy code 2086S0129X and a focus in Vascular Surgery.
