NPIMap

Individual provider Active NPI

Dylan Richard Foord, D.O.

  • Emergency Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1063683969
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO2982 Issued in NV
Practice address
620 Shadow LN
Las Vegas, NV 89106-4119
Phone
(702) 388-4000
NPI assigned
Mar 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO2982 NV Primary

Addresses

Primary practice location

620 Shadow LN
Las Vegas, NV 89106-4119

Mailing address

PO Box 370541
Las Vegas, NV 89137-0541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210915002532 NV Practitioner - Emergency Medicine 1052457074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO2982NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards MD PC Emergency Medicine CurrentSince Dec 3, 2024 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Foord Asset Management NV PLLC Current Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Acute Care Medical Coastal Emergency Medicine Past Accepting new patients

Locations

1155 Raiders Way
Henderson, NV 89052
Phone (702) 369-7671

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

Interoperability endpoints

  • Direct secure messaging: dylan.foord@1063601392123908.direct.elationemr.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1063683969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370541",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891370541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064119",
            "telephone_number": "702-388-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOORD",
        "first_name": "DYLAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-19",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "DO2982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.