NPIMap

Individual provider Active NPI

Ivo Mirtchev, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Las Vegas, NV
National Provider Identifier
1093187502
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
18766 Issued in NV
Practice address
4840 W Desert Inn Rd
Las Vegas, NV 89102-9125
Phone
(702) 248-1854
Fax
(702) 248-7042
NPI assigned
Oct 22, 2015
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18766 NV
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 18766 NV Primary

Addresses

Primary practice location

4840 W Desert Inn Rd
Las Vegas, NV 89102-9125

Mailing address

1906 Tanner Valley Cir
Las Vegas, NV 89123-2843
Phone (702) 460-4364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Fred Meyer Stores Inc Past Accepting new patients
Fred Meyer Stores Inc. Past Accepting new patients
Smiths Food & Drug Centers Inc PastSince Jan 26, 2020 Accepting new patients
Smith's Food & Drug Centers Inc PastSince Jan 26, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1093187502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 TANNER VALLEY CIR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891232843",
            "telephone_number": "702-460-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 W DESERT INN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891029125",
            "telephone_number": "702-248-1854",
            "fax_number": "702-248-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRTCHEV",
        "first_name": "IVO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-22",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "18766",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NV",
            "license": "18766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jan 24, 2020; 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.