Amir Bacchus, M. D. LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AMIR BACCHUS, M. D. LTD

Practice address

1701 N Green Valley Pkwy
Henderson, NV 89074-5885

Phone

(407) 316-3130

Fax

(407) 316-3001

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Amir Bacchus, M.D.

Title

Sole Owner

Phone

(407) 316-3130

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154495232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N MAGNOLIA AVE",
            "address_2": "SUITE 405",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033851",
            "telephone_number": "407-316-3130",
            "fax_number": "407-316-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GREEN VALLEY PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745885",
            "telephone_number": "407-316-3130",
            "fax_number": "407-316-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIR BACCHUS, M. D. LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACCHUS",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "407-316-3130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Henderson, NV
• Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.