Marisa C Medina MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MARISA C MEDINA MD PC

Practice address

11201 S Eastern #120
Henderson, NV 89052-6200

Phone

(702) 731-9711

Fax

(702) 731-0096

NPI assigned

Sep 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marisa C Medina, MDNPI 1285686832

Title

Doctor

Phone

(702) 932-9824

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Marisa Claudette Medina, MD

  • Internal Medicine Physician
  • Rapid City, SD
  • NPI 1285686832
  NPD (past) Authorized official
• Andrew Joseph Conlu, M.D.

  • Internal Medicine Physician
  • Gold Beach, OR
  • NPI 1528018447
  NPD (past)

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1104013739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 S EASTERN #120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890526200",
            "telephone_number": "702-731-9711",
            "fax_number": "702-731-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 S EASTERN #120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890526200",
            "telephone_number": "702-731-9711",
            "fax_number": "702-731-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARISA C MEDINA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "MARISA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "702-932-9824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Mariconda
• Maricondia Dental PC
• William Joseph Maricondia, DDS
• Marilyn G. Maschgan LTD
• Kyle Lyndon Maring, RPH
• Mark Bell MD PC
• Mark Burger DO LLC
• Mark Day, D.O., Inc
• Mark L Glyman MD DDS & Eric D Swanson MD DMD LTD
• Michelle Alicia Mark, D.O.

• Primary Care Clinic/Center in Henderson, NV
• Providers in Henderson, NV by specialty
• Primary Care Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.