Act Medical Group-Las Vegas Inc

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

ACT MEDICAL GROUP-LAS VEGAS INC

Practice address

500 N Rainbow Blvd Ste 300
Las Vegas, NV 89107-1061

Phone

(213) 476-9619

NPI assigned

May 15, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Maria V Macahia

Title

Secretary

Phone

(213) 476-9619

Specialties & licenses 1

Addresses

Electronic endpoints 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17181/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1124684030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11245 DELANO ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "91606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071061",
            "telephone_number": "213-476-9619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACT MEDICAL GROUP-LAS VEGAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "MACAHIA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "213-476-9619",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "customercare@actmedicalgroup.net",
            "affiliation": "N",
            "endpointDescription": "EHR Software main office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11245 Delano Street",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "91606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Las Vegas, NV
• Gerontology Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.