Active NPI
Pokroy Medical Group of Nevada, LTD.
- Pediatrics Physician
- Las Vegas, NV
National Provider Identifier
1093402489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- POKROY MEDICAL GROUP OF NEVADA, LTD.
- Practice address
- 3186 S Maryland Pkwy
Las Vegas, NV 89109-2317 - Phone
- (702) 961-2000
- NPI assigned
- Apr 18, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kristina H Deeter, MD
- Title
- President, Director
- Phone
- (800) 243-3839
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary | ||
| Neonatal-Perinatal Medicine Physician | 2080N0001X | |||
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | |||
| Pediatric Critical Care Medicine Physician | 2080P0203X | |||
| Pediatric Endocrinology Physician | 2080P0205X | |||
| Pediatric Infectious Diseases Physician | 2080P0208X | |||
| Pediatric Nurse Practitioner | 363LP0200X |
Addresses
Primary practice location
3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Mailing address
1301 Concord Ter
Sunrise, FL 33323-2843
Phone (800) 243-3839
National Provider Directory
National Provider Directory- Tax ID family
- Pokroy Medical Group of Nevada LTD
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Neonatal-Perinatal Medicine Physician
- Las Vegas, NV
- NPI 1013866185
-
- Neonatal-Perinatal Medicine Physician
- Henderson, NV
- NPI 1235890062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1681776000000",
"number": "1093402489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 CONCORD TER",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232843",
"telephone_number": "800-243-3839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3186 S MARYLAND PKWY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891092317",
"telephone_number": "702-961-2000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POKROY MEDICAL GROUP OF NEVADA, LTD.",
"organizational_subpart": "NO",
"enumeration_date": "2023-04-18",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A",
"authorized_official_last_name": "DEETER",
"authorized_official_first_name": "KRISTINA",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT, DIRECTOR",
"authorized_official_telephone_number": "800-243-3839",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
},
{
"code": "2080N0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0008X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0205X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Pediatric Endocrinology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0208X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Pediatrics",
"state": null,
"license": null,
"primary": false
}
],
"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 Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.