NPIMap

Organization Active NPI

Nevada Limb & Brace LLC

  • Prosthetic/Orthotic Supplier
  • Henderson, NV
National Provider Identifier
1124675848
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
NEVADA LIMB & BRACE LLC
Practice address
1505 Wigwam Pkwy Suite 141
Henderson, NV 89074-8195
Phone
(702) 899-1700
Fax
(702) 899-1813
NPI assigned
Aug 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Authorized official

Name
Ruben A Gardea
Title
Managing Member
Phone
(702) 899-1700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1505 Wigwam Pkwy Suite 141
Henderson, NV 89074-8195

Mailing address

1505 Wigwam Pkwy Suite 141
Henderson, NV 89074-8195
Phone (702) 899-1700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210621001111 NV DME Supplier - Medical Supply Company With Orthotic-Prosthetic 4183024615 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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Nevada Limb & Brace, LLC1505 Wigwam Pkwy, Henderson, NV 89074-8195(702) 899-1700 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jun 18, 2021

National Provider Directory

National Provider Directory

Locations

1505 Wigwam Pkwy
Ste 103
Henderson, NV 89074

1505 Wigwam Pkwy
Ste 141
Henderson, NV 89074
Phone (702) 899-1700

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1124675848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 WIGWAM PKWY SUITE 141",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748195",
            "telephone_number": "702-899-1700",
            "fax_number": "702-899-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WIGWAM PKWY SUITE 141",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748195",
            "telephone_number": "702-899-1700",
            "fax_number": "702-899-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA LIMB & BRACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-19",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "GARDEA",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-899-1700"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "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 May 13, 2020; 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.