St Rose Integrated Medical Center

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ST ROSE INTEGRATED MEDICAL CENTER

Practice address

10561 Jeffreys St Ste 100
Henderson, NV 89052-4267

Phone

(702) 405-6333

NPI assigned

Mar 19, 2019

Last updated

Jul 23, 2020By 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. Yvonne C Ortega, MD

Title

Ceo

Phone

(702) 405-6333

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1033678933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10561 JEFFREYS ST STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524267",
            "telephone_number": "702-405-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10561 JEFFREYS ST STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524267",
            "telephone_number": "702-405-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ROSE INTEGRATED MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-405-6333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Sri
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• St Rose Medical Supplies
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• Nicolas St. Clair
• St. Rose Family & Cosmetic Dentistry
• St.Agatha Home Health LLC

• Multi-Specialty Clinic/Center in Henderson, NV
• Providers in Henderson, NV by specialty
• Multi-Specialty Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.