NPIMap

Organization Active NPI

Prime Healthcare Services North Vista LLC

  • General Acute Care Hospital
  • North Las Vegas, NV
National Provider Identifier
1053718361
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
649HOS-34 Issued in NV
Legal business name
PRIME HEALTHCARE SERVICES NORTH VISTA LLC
Practice address
1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120
Phone
(702) 649-7711
NPI assigned
Dec 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Authorized official

Name
Prem Reddy
Title
Chairman/President
Phone
(909) 235-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 649HOS-34 NV Primary

Addresses

Primary practice location

1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120

Mailing address

1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120
Phone (702) 649-7711

Other identifiers 3

IdentifierTypeStateIssuer
100502301MedicaidNV
100502300MedicaidNV
100502299MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services North Vista LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1053718361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307120",
            "telephone_number": "702-649-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307120",
            "telephone_number": "702-649-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES NORTH VISTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "PREM",
        "authorized_official_title_or_position": "CHAIRMAN/PRESIDENT",
        "authorized_official_telephone_number": "909-235-4400"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NV",
            "license": "649HOS-34",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502301",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502300",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502299",
            "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 Dec 2, 2014; 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.