Organization Active NPI

Concierge Care Physicians, LLP

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1104850163
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CONCIERGE CARE PHYSICIANS, LLP
Practice address
2450 W Horizon Ridge Pkwy Ste 150
Henderson, NV 89052-2722
Phone
(702) 990-0622
Fax
(702) 938-1473
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Authorized official

Name
Dr. Russell N. Neibaur, M.D.
Title
Physician
Phone
(702) 990-0622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2450 W Horizon Ridge Pkwy Ste 150
Henderson, NV 89052-2722

Mailing address

2450 W Horizon Ridge Pkwy Ste 150
Henderson, NV 89052-2722
Phone (702) 990-0622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060918000208 NV Part B Supplier - Clinic/Group Practice 3678578051 Receives reassigned benefits from 3 practitioners
Practice locations: Henderson, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2106943Concierge Care Physicians2450 W Horizon Ridge Pkwy Ste 150, Henderson, NV 89052Certificate of waiverJan 3, 2028

National Provider Directory

National Provider Directory

Locations

861 Coronado Center Dr
Ste 103
Henderson, NV 89052
Phone (702) 998-0622

Practitioners & affiliated clinicians

Practitioners 3

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": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1104850163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HORIZON RIDGE PKWY STE 150",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522722",
            "telephone_number": "702-990-0622",
            "fax_number": "702-938-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 W HORIZON RIDGE PKWY STE 150",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522722",
            "telephone_number": "702-990-0622",
            "fax_number": "702-938-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCIERGE CARE PHYSICIANS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "NEIBAUR",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "702-990-0622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.