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SOUTHPARK VASCULAR CENTER
NPI 1962046763
Internal Medicine - Interventional Cardiology in Colonial Heights, VA

Active since November 05, 2019
445 CHARLES H DIMMOCK PKWY STE 101, COLONIAL HEIGHTS, VA 23834(804) 520-1764(866) 781-3220 Get Directions Write a Review

NPPES record last updated: November 5, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Southpark Vascular Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHPARK VASCULAR CENTER (NPI 1962046763) is a healthcare organization registered as an interventional cardiology in Colonial Heights, Virginia and active in the NPI registry since November 2019. The organization lists Janet Dees, President, as its authorized official.

NPPES Registry Identity

NPI1962046763
Entity TypeOrganization
Primary Taxonomy207RI0011X
Legal Business NameSOUTHPARK VASCULAR CENTER
Location Address445 CHARLES H DIMMOCK PKWY STE 101Colonial Heights, VA 23834-2990
Mailing Address3001 Palm Harbor Blvd Ste APalm Harbor, FL 34683-1930 · (727) 214-0462 · Fax (727) 474-0055
Phone(804) 520-1764
Fax(866) 781-3220
Organization SubpartNo
Authorized OfficialJanet DeesPresident · (727) 214-0462
Enumeration DateNovember 5, 2019
✔ NPI 1962046763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
445 CHARLES H DIMMOCK PKWY STE 101, Colonial Heights, VA 23834
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southpark Vascular Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Southpark Vascular Center, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Mitesh Amin, MD
Cardiovascular Disease (Cardiology)
NPI 1801003157
445 CHARLES H DIMMOCK PKWY SUITE 100
Colonial Heights, VA 23834
(804) 520-1764
✔ PECOS✔ Accepts MedicareSame address
Jaspreet Singh, MD
Cardiovascular Disease (Cardiology)
NPI 1942495312
445 CHARLES H DIMMOCK PKWY STE 100
Colonial Heights, VA 23834
(804) 520-1764
✔ PECOS✔ Accepts MedicareSame address
Tiffany Raikes, FNP-C
Nurse Practitioner
NPI 1861124588
524 SOUTHPARK BLVD
Colonial Heights, VA 23834
(804) 504-7980
✔ PECOS1.6 mi
Paul Butros, MD
Diagnostic Radiology
NPI 1316142029
550 BROADVIEW AVE STE 102
Warrenton, VA 20186
(540) 680-3433
✔ PECOS✔ Accepts Medicare104 mi
George Eigbire, M.D.
Interventional Cardiology
NPI 1093165367
619 E MASON ST
Springfield, IL 62701
(217) 788-0706
✔ PECOS686 mi

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 Southpark Vascular Center's NPI number?

The NPI number for Southpark Vascular Center is 1962046763. It was assigned to this organization in the NPPES registry on November 5, 2019.

Where is Southpark Vascular Center located?

Southpark Vascular Center is located at 445 Charles H Dimmock Pkwy Ste 101, Colonial Heights, VA 23834. The listed phone number is (804) 520-1764.

What is Southpark Vascular Center's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Southpark Vascular Center enrolled in Medicare?

Yes. Southpark Vascular Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southpark Vascular Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Southpark Vascular Center, in Cardiovascular Disease (Cardiology), Diagnostic Radiology, Interventional Cardiology and Nurse Practitioner. 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, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southpark Vascular Center was last updated on November 5, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.