NPIMap

Organization Active NPI

Bedrock Medical LLC

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1003415241
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BEDROCK MEDICAL LLC
Practice address
2235 E Flamingo Rd Ste 144
Las Vegas, NV 89119-0806
Phone
(702) 272-9500
NPI assigned
Oct 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Mrs. Munachimso AnyanwuNPI 1699392050
Title
President
Phone
(702) 272-9500

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2235 E Flamingo Rd Ste 144
Las Vegas, NV 89119-0806

Mailing address

2235 E Flamingo Rd Ste 144
Las Vegas, NV 89119-0806
Phone (702) 272-9500

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1003415241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 E FLAMINGO RD STE 144",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891190806",
            "telephone_number": "702-272-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 E FLAMINGO RD STE 144",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891190806",
            "telephone_number": "702-272-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDROCK MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "ANYANWU",
        "authorized_official_first_name": "MUNACHIMSO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-272-9500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "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 Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.