NPIMap

Organization Active NPI

R Muthaiah MD PC

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1124170493
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
R MUTHAIAH MD PC
Doing business as
CANYON MEDICAL CENTER
Practice address
5061 N Rainbow Blvd Ste 180
Las Vegas, NV 89130-1689
Phone
(702) 220-8001
Fax
(702) 395-4500
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Ramanathan Muthaiah, MDNPI 1356367734
Title
Owner
Phone
(702) 220-8001

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

5061 N Rainbow Blvd Ste 180
Las Vegas, NV 89130-1689

Mailing address

5061 N Rainbow Blvd Ste 180
Las Vegas, NV 89130-1689
Phone (702) 220-8001

Other names 1

  • CANYON MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050923000337 NV Part B Supplier - Clinic/Group Practice 3577597046 Receives reassigned benefits from 6 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

5061 N Rainbow Blvd
Ste 180
Las Vegas, NV 89130
Phone (702) 220-8001

Practitioners & affiliated clinicians

Practitioners 6

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1124170493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5061 N RAINBOW BLVD STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891301689",
            "telephone_number": "702-220-8001",
            "fax_number": "702-395-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5061 N RAINBOW BLVD STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891301689",
            "telephone_number": "702-220-8001",
            "fax_number": "702-395-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R MUTHAIAH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "MUTHAIAH",
        "authorized_official_first_name": "RAMANATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-220-8001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CANYON MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.