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With a combination of clinical and administrative experience, Chief Executive Officer Annette Small leads the day-to-day and strategic business aspects of the Midwest Aortic & Vascular Institute so that the surgeons can focus on what they do best, take excellent care of patients. She leads a top-notch team of clinical and operational staff to ensure a patient experience that is second to none.

Annette Small
Annette Small, MBA, BSN, RN


Annette Small is a highly accomplished professional with a remarkable blend of clinical and business experience, earning her the respect and trust of surgeon owners in the medical industry. With her exceptional skills and leadership, Annette has played a pivotal role in guiding MAVI to new heights.  In her first year at Kansas City Vascular, P.C., Annette orchestrated the successful merger of the group with Vascular Surgery Associates, P.C., resulting in the formation of MAVI. This strategic move positioned MAVI as the largest independent vascular surgery practice in the region, establishing its prominence and solidifying its market position.  Prior to joining Kansas City Vascular, P.C. in 2015, Annette held the position of Chief Operating Officer at Adams Dairy Bank in Blue Springs, Missouri. During her tenure, she played a key role in supporting the bank's strategic efforts to grow core deposits, while fostering a culture of exceptional customer service and community-based banking.  Annette's commitment to serving the community extended beyond the banking sector. As the Chief Executive Officer of St. Mary's Medical Center for over five years, she led a significant organizational transformation in 2009. Annette focused on rebuilding the organizational culture and implemented numerous initiatives to enhance service quality, improve profitability, and most importantly, foster engagement among patients and medical staff.  With her extensive experience in healthcare administration, banking, and executive leadership, Annette Small brings a wealth of expertise to her current role. Her dedication, strategic vision, and ability to foster strong relationships have proven instrumental in driving the success of MAVI and positioning it as a leader in the vascular surgery field.

Nikki Kramer
Nikki Kramer, RN 
Clinical Manager 

Nikki Kramer is a highly accomplished clinical manager at MAVI, where she plays a vital role in patient care operations. With a deep commitment to improving patient outcomes, Nikki works closely with MAVI's clinical staff to ensure optimal efficiency and quality care for our patients.  Nikki's journey in the healthcare field began with invaluable experience in an acute care hospital, where she worked across diverse departments, including medical-surgical, telemetry, interventional radiology, and clinical outcomes. Drawing from over 15 years of hands-on nursing experience and leadership, Nikki's exceptional skills set her apart, eventually leading her to join MAVI in January 2016.  Nikki assumed the role of clinical research coordinator at MAVI in September 2016 and has rapidly grown in her responsibilities and accomplishments in her leadership role. Her extensive knowledge and expertise contribute to the advancement and development of process improvement for MAVI and our patients.  Nikki's educational background consists of Licensed Practical Nursing and Associate of Science degrees in nursing from Penn Valley Community College. Nikki's unwavering commitment to advancing vascular disease management and her dedication to patient care make her an invaluable asset to MAVI.


Terri Self

Revenue Cycle Manager

Terri Selfis a highly accomplished professional serving as the Revenue Cycle Manager at MAVI. In this role, Terri undertakes the crucial responsibility of overseeing the day-to-day billing operations and ensuring the accuracy and timeliness of all payment issues. With an impressive career spanning over 21 years, Terri brings a wealth of expertise to MAVI, acquired during her tenure as a Patient Representative at St. Mary's Medical Center in Blue Springs, Missouri.  Terri's specialization lies in helping patients navigate the often complex and confusing insurance process. Her compassionate approach and in-depth understanding of the healthcare system enable her to provide invaluable assistance to patients, ensuring they receive the financial support they require while maintaining their peace of mind.  Terri holds a degree from Central Missouri State University, which has provided her with a strong foundation in healthcare management and patient advocacy. Her exceptional skills, combined with her extensive experience, make her an invaluable asset to MAVI's operations.

Rita Spurgeon, RVT, RPhS
Technical Director, Ultrasound and Vein Care

With over 19 years of experience in the industry, Rita Spurgeon joined MAVI in 2020 and has been making significant contributions to the vascular field ever since. Rita holds two prestigious vascular-specific credentials: she is a registered vascular technologist (RVT) and a Registered Phlebology Sonographer (RPhS). These credentials reflect her extensive knowledge and proficiency in performing non-invasive vascular ultrasound testing. Rita's passion for her work goes beyond the technical aspects of ultrasound; she genuinely cares about providing a comprehensive and positive patient care experience.  In her role at MAVI, Rita collaborates closely with physicians to aid in the diagnosis and treatment of various disorders affecting the vascular system. Her attention to detail and commitment to ensuring high-quality clinical results are instrumental in delivering accurate and reliable diagnoses.  Rita's educational background includes an applied sciences degree in Vascular Sonography from Southeast Technical College in South Dakota. Currently, she is pursuing a degree in Biomedical Sciences in Diagnostic Imaging from the University of Wisconsin.  Rita Spurgeon's wealth of experience, vascular expertise, and genuine dedication to patient care make her an outstanding professional in her field. Her contributions to MAVI and the healthcare community as a whole are invaluable, and she continues to strive for excellence in her pursuit of knowledge and advancement in her career.

Tina Rozycki 
Administrative Assistant

Tina Rozycki is a dedicated and experienced professional known for her exceptional skills and unwavering passion for helping others. With 16 years as a self-employed massage therapist, Tina has cultivated a deep understanding of the human body and a keen ability to provide therapeutic care.  Beyond her extensive experience in massage therapy, Tina has also spent several years in quality assurance and training within the telecommunications industry. Her attention to detail and commitment to delivering excellence have allowed her to develop and implement effective quality control processes, ensuring the highest quality support for patients and physicians.  Tina has been with MAVI for over a year and quickly mastered her clinical support role leading her to be promoted to support the Administration team as an Administrative Assistant. Tina is meticulous in her work, has excellent communication skills and has the best "can do" attitude-she is the perfect fit for our organization.

Samantha Wratchford
Administrative Assistant

Samantha Wratchford is a highly accomplished professional with a remarkable career trajectory spanning over seven years at MAVI, where she has exhibited exceptional growth and contributed significantly to the organization's success.  Samantha began as a new Medical Assistant out of school and quickly mastered her clinical support role leading her to be promoted to support the Administration team as an Administrative Assistant.  Samantha's dedication to continuous improvement and her passion for delivering exceptional results have been instrumental in her career growth at MAVI.


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