Nevada Health Centers Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Las Vegas, NV
NPI 1073688198 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1073688198
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- NEVADA HEALTH CENTERS INC
- Practice address
- 3900 Cambridge St
Suite 102
Las Vegas, NV 89119-7439 - Phone
- (702) 307-5415
- Fax
- (702) 307-5416
- NPI assigned
- Nov 22, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- NEVADA HEALTH CENTERS INC
Authorized official
- Name
- Walter B Davis
- Title
- Ceo
- Phone
- (775) 888-6610
Owners & managing parties with NPI records 24
Owned or controlled facilities with NPI records 13
Other NPIs on the same Medicare enrollment 34
Other NPIs with the same Medicare PAC ID 24
Facilities with the same owner 13
Practitioners 42
-
Steven H Cerna, APRN
-
Michelle Sernas, LCSW
-
Jeremy Dane Sporrong, D.O.
-
Madelaine Heidi Coquelet-Meyer, MFT, LCADC
-
Sarah Draves, APRN
-
Ashwitha Francis, MD
-
Rachel Elizabeth Grant, FNP-C
-
Gayle Harris, APRN
-
Amanda Lauren Horton, APRN
-
Mylinda Barrick Houser, LCSW
-
Sandra Fay Lewis, LCSW
-
Steve Lore, MD
-
Karina J Luera, DO
-
Elyse Muratore, MD
-
Ertha A Nanton, MD
-
Michael W Owens, MD
-
Amol Patel, MD
-
Rhianna Michelle Perez, MSN, FNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D0999815 | Cambridge Family Health Center | Certificate of waiver | May 22, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV
Federally qualified health center certification: CCN 291829
- Legal name
- NEVADA HEALTH CENTERS INC
- Doing business as
- CAMBRIDGE FAMILY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 30, 2003
- Last certification
- Jan 30, 2003
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 22, 1992 in NV
- Enrollment address
- 3900 Cambridge St 102
Las Vegas, NV 89119-7440
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Donald E Chaney |
Corporate Director | Aug 1, 2012 | |
| Mary L Kieffer |
Corporate Director |
May 15, 2015 | |
| Alicia Y Barnes |
Corporate Director | Aug 1, 2012 | |
| Gerald Ackerman |
Corporate Director | Mar 1, 2011 | |
| Linda Bingaman |
Corporate Director |
May 15, 2015 | |
| Kathryn L Triplett |
Corporate Officer |
Oct 1, 2016 | 100% |
| W-2 Managing Employee |
Oct 1, 2016 | 100% | |
| Nevada Health Centers Inc |
Operational/Managerial Control | Oct 1, 2013 | 100% |
| Maurice Washington |
Corporate Director |
May 15, 2015 | |
| Jared Carter |
Corporate Director | Jun 5, 2009 | |
| Adriana Fralick |
Corporate Director |
May 15, 2015 | |
| Walter B Davis |
Corporate Officer |
Nov 26, 2012 | 100% |
| W-2 Managing Employee |
Nov 26, 2012 | 100% |
All facility ownership & control disclosures 13
| Facility | Type | Role | Since |
|---|---|---|---|
| North Las Vegas Family Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | May 3, 2013 |
| Eastern Family Medical and Dental Center |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 2010 |
| Jackpot Community Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 1999 |
| Henderson Family Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 18, 2015 |
| Nevada Health Centers Carson City School Based |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 21, 2015 |
| Nevada Health Centers at Virginia City |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 29, 2015 |
| Nevada Children'S Health Project |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 26, 2018 |
| Nevada Health Centers at Enterprise |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | May 10, 2019 |
| Willow Street Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 22, 2023 |
| Mobile Medical Services 1 |
Federally qualified health center | 5% Or Greater Direct Ownership Interest | Dec 29, 2023 |
| Mobile Dental Services 1 |
Federally qualified health center | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 |
| Nellis Family Medical & Dental Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 9, 2024 |
| Pahrump Family Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 8, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20021207000002 | NV | Part a Provider - Federally Qualified Health Center (FQHC) | 7113835307 | Practice locations: Las Vegas, NV |
| O20040219000452 | NV | Part B Supplier - Clinic/Group Practice | 7113835307 |
Receives reassigned benefits from 65 practitioners 34 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Las Vegas, NV; North Las Vegas, NV; Pahrump, NV; Reno, NV; Virginia City, NV; West Wendover, NV; Amargosa Valley, NV; Austin, NV… |
National Provider Directory
- Part of
- Nevada Rural Health Cen
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | NV | Yes |
Addresses
Primary practice location
3900 Cambridge St
Suite 102
Las Vegas, NV 89119-7439
Mailing address
3325 Research Way
Carson City, NV 89706-7913
Phone (775) 888-6610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073688198 | Medicaid | NV | |
| DQ468A | Other | NV | MEDICARE ID - TYPE UNSPECIFIED |
Other names
- Cambridge Family Health Center
Other providers in Las Vegas, NV
- Nevada Health Alliance Inc
- Nevada Health Alliance Inc
- Nevada Health Alliance Inc
- Nevada Health and Wellness Center LLC
- Nevada Health Care Group, LLC
- Nevada Health Centers Inc
- Nevada Health Centers Inc
- Nevada Health Centers Inc
- Nevada Health Centers Inc
- Nevada Health Centers Inc
All providers in Las Vegas, NV · Federally Qualified Health Center (FQHC) in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.