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Organization Active NPI

Gorman Moapa Valley Family Pratice PLLC Michael J Gorman Sole MBR

  • Family Medicine Physician
  • Logandale, NV
National Provider Identifier
1073762894
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO1423 Issued in NV
Legal business name
GORMAN MOAPA VALLEY FAMILY PRATICE PLLC MICHAEL J GORMAN SOLE MBR
Practice address
1925 Whipple Ave
Ste 30
Logandale, NV 89021
Phone
(702) 398-3621
Fax
(702) 398-3639
NPI assigned
Sep 17, 2008
Last updated
Sep 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Dr. Michael Justin Gorman, D.O.
Title
Physician / Owner
Phone
(702) 398-3621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO1423 NV Primary

Addresses

Primary practice location

1925 Whipple Ave
Ste 30
Logandale, NV 89021

Mailing address

PO Box 357
Logandale, NV 89021-0357
Phone (702) 398-3621

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1073762894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "LOGANDALE",
            "state": "NV",
            "postal_code": "890210357",
            "telephone_number": "702-398-3621",
            "fax_number": "702-398-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 WHIPPLE AVE",
            "address_2": "STE 30",
            "city": "LOGANDALE",
            "state": "NV",
            "postal_code": "89021",
            "telephone_number": "702-398-3621",
            "fax_number": "702-398-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORMAN MOAPA VALLEY FAMILY PRATICE PLLC MICHAEL J GORMAN SOLE MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "702-398-3621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO1423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logandale, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.