NPIMap

Organization Active NPI

Garnet Medical Clinic

Doing business as Garnet Medical Clinic LLC

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1093582512
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GARNET MEDICAL CLINIC
Doing business as
Garnet Medical Clinic LLC
Practice address
9488 W Flamingo Rd Ste 100
Las Vegas, NV 89147-5717
Phone
(702) 275-4487
NPI assigned
Dec 5, 2023
Last updated
Apr 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Delsa A Dagalea, APRNNPI 1457581993
Title
Provider
Phone
(702) 275-4487

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

9488 W Flamingo Rd Ste 100
Las Vegas, NV 89147-5717

Mailing address

9488 W Flamingo Rd Ste 100
Las Vegas, NV 89147-5717
Phone (702) 275-4487

Other names 2

  • GARNET MEDICAL CLINIC Other name
  • Garnet Medical Clinic LLC Doing business as

National Provider Directory

National Provider Directory

Locations

9488 W Flamingo Rd
#100S100
Las Vegas, NV 89147

9488 W Flamingo Rd
Ste 100
Las Vegas, NV 89147
Phone (702) 275-4487

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1093582512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9488 W FLAMINGO RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891475717",
            "telephone_number": "702-275-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9488 W FLAMINGO RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891475717",
            "telephone_number": "702-275-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARNET MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-05",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "DAGALEA",
        "authorized_official_first_name": "DELSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "702-275-4487",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GARNET MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Garnet Medical Clinic LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GARNET MEDICAL CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 23, 2024; 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.