Organization Active NPI

Adrian Adrian a Professional Corporation

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1043461296
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADRIAN ADRIAN A PROFESSIONAL CORPORATION
Practice address
5940 S Rainbow Blvd
Las Vegas, NV 89118-2540
Phone
(702) 335-1880
NPI assigned
Oct 7, 2008
Last updated
Nov 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Authorized official

Name
Adrian Adrian, MDNPI 1174577662
Title
President
Phone
(702) 335-1880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X NV Primary

Addresses

Primary practice location

5940 S Rainbow Blvd
Las Vegas, NV 89118-2540

Mailing address

5940 S. Rainbow
Las Vegas, NV 89118
Phone (702) 335-1880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090901000381 NV Part B Supplier - Clinic/Group Practice 0244385904 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2325 E Harmon Ave
Las Vegas, NV 89119
Phone (702) 798-1990

Practitioners & affiliated clinicians

Practitioners 1

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": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1043461296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 S. RAINBOW",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89118",
            "telephone_number": "702-335-1880",
            "fax_number": "702-798-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182540",
            "telephone_number": "702-335-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADRIAN ADRIAN A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "ADRIAN",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-335-1880",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "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 Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.