Chanwell Medical Group Nevada Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

42535 Issued in CA

Legal business name

CHANWELL MEDICAL GROUP NEVADA INC

Practice address

2749 Sunridge Heights Pkwy
Henderson, NV 89052-5044

Phone

(702) 568-0686

Fax

(702) 568-0687

NPI assigned

Apr 18, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Quan Chan, M.D

Title

President

Phone

(702) 568-0686

Specialties & licenses 4

Addresses

Other names 1

• CHANWELL CLINIC Doing business as

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1124385976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 LAS VEGAS BLVD S UNIT 3501W",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891584399",
            "telephone_number": "408-828-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2749 SUNRIDGE HEIGHTS PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525044",
            "telephone_number": "702-568-0686",
            "fax_number": "702-568-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANWELL MEDICAL GROUP NEVADA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "QUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-568-0686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "042535",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "42535",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A35593",
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "CA",
            "license": "042535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHANWELL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHANWELL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Celes Chang, APRN
• Ning Chang, DDS
• Changing Destiny Behavioral Health
• Changing Minds Medicine LLC
• Changing Minds Psychiatry LLC
• Barbara Chapman
• Sallie Chapman
• Shari Lynn Chapman
• Wanda Chapman
• Keira Sharell Chapple

• Multi-Specialty Clinic/Center in Henderson, NV
• Providers in Henderson, NV by specialty
• Multi-Specialty Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.