Organization Active NPI

AIDS Healthcare Foundation

  • Clinic/Center
  • North Las Vegas, NV
National Provider Identifier
1053746933
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
AIDS HEALTHCARE FOUNDATION
Practice address
1815 E Lake Mead Blvd
Suite 113
North Las Vegas, NV 89030-7187
Phone
(323) 436-5019
NPI assigned
Sep 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Authorized official

Name
Donna Stidham
Title
Chief of Managed Care
Phone
(323) 436-5025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1815 E Lake Mead Blvd
Suite 113
North Las Vegas, NV 89030-7187

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050525000558 FL Part B Supplier - Clinic/Group Practice 2668369109 Receives reassigned benefits from 75 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami Beach, FL; Ft Lauderdale, FL; North Miami Beach, FL; Orlando, FL; Pensacola, FL; Safety Harbor, FL; St Petersburg, FL; Tampa, FL…
O20140401001219 NV Part B Supplier - Clinic/Group Practice 2668369109 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV; North Las Vegas, NV

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory

Locations

8390 Champions Gate Blvd
Champions Gate, FL 33896
Phone (407) 479-2000

NPI Registry JSON

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1053746933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200",
            "fax_number": "833-241-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E LAKE MEAD BLVD",
            "address_2": "SUITE 113",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307187",
            "telephone_number": "323-436-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIDS HEALTHCARE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "STIDHAM",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CHIEF OF MANAGED CARE",
        "authorized_official_telephone_number": "323-436-5025"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 11, 2019; 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.