Organization Active NPI

Summit Integrated Health of Nevada

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1043053390
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SUMMIT INTEGRATED HEALTH OF NEVADA
Practice address
2670 Crimson Canyon Dr Ste 150
Las Vegas, NV 89128-0848
Phone
(702) 232-3189
Fax
(702) 726-9543
NPI assigned
Jun 14, 2024
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Sherryl Cuaderno Takahashi
Title
Billing Manager
Phone
(702) 233-6196

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary
Chiropractor 111N00000X NU

Addresses

Primary practice location

2670 Crimson Canyon Dr Ste 150
Las Vegas, NV 89128-0848

Mailing address

2670 Crimson Canyon Dr Ste 150
Las Vegas, NV 89128-0848
Phone (702) 232-3189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240808003455 NV Part B Supplier - Clinic/Group Practice 2860939790 Receives reassigned benefits from 8 practitioners
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Summit Integrated Health of Nevada2670 Crimson Canyon Dr, Las Vegas, NV 89128-0848(702) 636-2843 Orthoses: Prefabricated (Non-Custom Fabricated) Accepts assignmentParticipating since Jul 25, 2024

National Provider Directory

National Provider Directory

Locations

2670 Crimson Canyon Dr
Ste 150
Las Vegas, NV 89128
Phone (702) 359-7246

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1043053390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 CRIMSON CANYON DR STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280848",
            "telephone_number": "702-232-3189",
            "fax_number": "702-726-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 CRIMSON CANYON DR STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280848",
            "telephone_number": "702-232-3189",
            "fax_number": "702-726-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT INTEGRATED HEALTH OF NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "TAKAHASHI",
        "authorized_official_first_name": "SHERRYL",
        "authorized_official_middle_name": "CUADERNO",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "702-233-6196"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.