NPIMap

Organization Active NPI

Nevada Medical Systems, Inc.

  • Methadone Clinic
  • North Las Vegas, NV
National Provider Identifier
1043393309
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
NEVADA MEDICAL SYSTEMS, INC.
Practice address
2516 E Lake Mead Blvd
North Las Vegas, NV 89030-6414
Phone
(702) 399-1600
Fax
(702) 399-5375
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Authorized official

Name
Mr. Brant Massman
Title
Owner
Phone
(702) 399-1600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 1938NTC-10 NV
Methadone Clinic 261QM2800X NV Primary

Addresses

Primary practice location

2516 E Lake Mead Blvd
North Las Vegas, NV 89030-6414

Mailing address

PO Box 897
Boise, ID 83701
Phone (702) 399-1600

Other identifiers 1

IdentifierTypeStateIssuer
100502427MedicaidNV

National Provider Directory

National Provider Directory

Locations

2516 E Lake Mead Blvd
North Las Vegas, NV 89030
Phone (702) 399-1600

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1043393309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83701",
            "telephone_number": "702-399-1600",
            "fax_number": "702-399-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890306414",
            "telephone_number": "702-399-1600",
            "fax_number": "702-399-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA MEDICAL SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "MASSMAN",
        "authorized_official_first_name": "BRANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-399-1600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NV",
            "license": "1938NTC-10",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502427",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.