Individual provider Active NPI

Brandon Ludwig, FNP

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1013654599
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
853830 Issued in NV
Practice address
4490 N Rancho Dr
Las Vegas, NV 89130-3406
Phone
(702) 655-0550
Fax
(702) 655-0545
NPI assigned
May 17, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 853830 NV Primary

Addresses

Primary practice location

4490 N Rancho Dr
Las Vegas, NV 89130-3406

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other identifiers 2

IdentifierTypeStateIssuer
853830OtherNVSTATE LICENSE
1013654599MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231011002097 TX Practitioner - Nurse Practitioner 5698158210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ashwin Gowda MD PAGroup PAC ID 9931275898, 7 clinicians

Practice addresses (Care Compare)

8500 Bluffstone CV
Suite A101
Austin, TX 78759-7809
Phone (512) 440-5757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
853830NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ashwin Gowda MD PA Single Specialty CurrentSince May 13, 2023 Accepting new patients

Locations

8500 Bluffstone Cv
Ste A101
Austin, TX 78759
Phone (512) 328-2102

1221 W Ben White Blvd
Ste 100A
Austin, TX 78704
Phone (512) 440-5757

Interoperability endpoints

  • Direct secure messaging: brandon.ludwig.1@11417.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11417/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1013654599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 N RANCHO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303406",
            "telephone_number": "702-655-0550",
            "fax_number": "702-655-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWIG",
        "first_name": "BRANDON",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "853830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "853830",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013654599",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.