Plaxia Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PLAXIA CARE LLC

Practice address

5095 N Park St
Las Vegas, NV 89149-2522

Phone

(702) 858-4559

Fax

(810) 885-0572

NPI assigned

Nov 13, 2020

Organization subpart

No

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

Authorized official

Name

Nichole Crock, ADMINISTRATOR

Title

Owner

Phone

(702) 858-4559

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1013519073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4565 N CHIEFTAIN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891292608",
            "telephone_number": "702-858-4559",
            "fax_number": "810-885-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5095 N PARK ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891492522",
            "telephone_number": "702-858-4559",
            "fax_number": "810-885-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAXIA CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "CROCK",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-858-4559",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE",
            "identifier": "NV20191673366",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AND HUMAN SERVICES DIVISION OF PUBIC AND BEHAVIORAL HEALTH",
            "identifier": "10219-AGC-0",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Assisted Living Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.