Organization Active NPI

Tamara Gutierrez, LLC

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1003016072
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
484 Issued in NV
Legal business name
TAMARA GUTIERREZ, LLC
Practice address
3870 E Flamingo Rd Ste A3
Las Vegas, NV 89121-6241
Phone
(702) 434-9919
Fax
(702) 270-0926
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Tamara Lisa Gutierrez, ODNPI 1396809927
Title
Optometrist
Phone
(702) 769-5755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 484 NV Primary

Addresses

Primary practice location

3870 E Flamingo Rd Ste A3
Las Vegas, NV 89121-6241

Mailing address

2429 Amoretti St
Henderson, NV 89052-5757
Phone (702) 769-5755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070828000012 NV Part B Supplier - Clinic/Group Practice 3476645037 Receives reassigned benefits from 3 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

3870 E Flamingo Rd
Ste A3
Las Vegas, NV 89121
Phone (702) 434-9919

7775 S Rainbow Blvd
Ste 110
Las Vegas, NV 89139
Phone (702) 648-1515

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1003016072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 AMORETTI ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525757",
            "telephone_number": "702-769-5755",
            "fax_number": "702-270-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 E FLAMINGO RD STE A3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891216241",
            "telephone_number": "702-434-9919",
            "fax_number": "702-270-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMARA GUTIERREZ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "702-769-5755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.