NPIMap

Organization Active NPI

Physicians of America

  • Child & Adolescent Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1083239925
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
PHYSICIANS OF AMERICA
Practice address
10785 W Twain Ave Ste 219
Las Vegas, NV 89135-3028
Phone
(702) 246-2620
NPI assigned
Jun 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Timothy Jeider, MD
Title
Medical Director
Phone
(702) 246-2620

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

10785 W Twain Ave Ste 219
Las Vegas, NV 89135-3028

Mailing address

3375 S Rainbow Blvd # 81857
Las Vegas, NV 89146-9995

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address contact@poanp.org Direct

National Provider Directory

National Provider Directory

Locations

3375 S Rainbow Blvd
#81857
Las Vegas, NV 89146

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1083239925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 S RAINBOW BLVD # 81857",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891469995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10785 W TWAIN AVE STE 219",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891353028",
            "telephone_number": "702-246-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "JEIDER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-246-2620",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@poanp.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10785 W Twain Ave Ste 219",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891353028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.