Redrock Renal Group LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

2000115.426 Issued in NV

Legal business name

REDROCK RENAL GROUP LLC

Practice address

5751 S Fort Apache Rd
Suite 1110
Las Vegas, NV 89148-5624

Phone

(702) 586-0007

Fax

(702) 586-0009

NPI assigned

Aug 19, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Galen Robert Bennett, BSBA

Title

Ceo / Administrator

Phone

(702) 586-0007

Specialties & licenses 1

Addresses

Tax ID family

Redrock Renal Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Redrock Renal Group

  • Medical Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1366620601
  NPD tax ID

Locations

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1144477498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 S FORT APACHE RD",
            "address_2": "SUITE 1110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485624",
            "telephone_number": "702-586-0007",
            "fax_number": "702-586-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 S FORT APACHE RD",
            "address_2": "SUITE 1110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485624",
            "telephone_number": "702-586-0007",
            "fax_number": "702-586-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDROCK RENAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "GALEN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CEO / ADMINISTRATOR",
        "authorized_official_telephone_number": "702-586-0007",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSBA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NV",
            "license": "2000115.426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Redpath, DPT
• Redrock Chiropractic Inc (RedRock Chiropractic)
• Redrock Renal Care LLC
• Redrock Renal Care LLC
• Redrock Renal Group
• Stephanie L Redwine, RDH, BS
• Lamija Redzic
• Nusret Redzic
• Melissa Jean Reece-Thompson
• Amber Ann Reece

• Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.