Medical Associates of Southern Nevada

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

1001 Issued in NV

Legal business name

MEDICAL ASSOCIATES OF SOUTHERN NEVADA

Practice address

9975 S Eastern Ave
110A
Las Vegas, NV 89183-7949

Phone

(702) 492-7208

Fax

(702) 407-5645

NPI assigned

Oct 22, 2010

Last updated

Oct 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Govind Venkata Koka, DO

Title

President

Phone

(702) 492-7208

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1023318177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778195",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890778195",
            "telephone_number": "702-492-7208",
            "fax_number": "702-407-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9975 S EASTERN AVE",
            "address_2": "110A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837949",
            "telephone_number": "702-492-7208",
            "fax_number": "702-407-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF SOUTHERN NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "KOKA",
        "authorized_official_first_name": "GOVIND",
        "authorized_official_middle_name": "VENKATA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-492-7208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NV",
            "license": "1001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DO LICENSE NV1001",
            "identifier": "NV1001",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.