Randa Bascharon D.O., Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

1103 Issued in NV

Legal business name

RANDA BASCHARON D.O., INC

Practice address

6850 N Durango Dr
#218
Las Vegas, NV 89149-4595

Phone

(702) 947-7790

Fax

(702) 947-7792

NPI assigned

Jun 10, 2006

Organization subpart

No

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

Authorized official

Name

Randa Amin Bascharon, DO

Title

Owner Pres Sec Etc

Phone

(702) 596-0036

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• ORTHOPEDIC & SPORTS MEDICINE INSTITUTE OF LAS VEGAS Doing business as

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1174564009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 S RAINBOW BLVD",
            "address_2": "#393",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891033106",
            "telephone_number": "702-596-0036",
            "fax_number": "702-947-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 N DURANGO DR",
            "address_2": "#218",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494595",
            "telephone_number": "702-947-7790",
            "fax_number": "702-947-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDA BASCHARON D.O., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "BASCHARON",
        "authorized_official_first_name": "RANDA",
        "authorized_official_middle_name": "AMIN",
        "authorized_official_title_or_position": "OWNER PRES SEC ETC",
        "authorized_official_telephone_number": "702-596-0036",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NV",
            "license": "1103",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "20A8358",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NV",
            "license": "1103",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "20A8358",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIF MEDI-CAL",
            "identifier": "XTE006922",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503044",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ORTHOPEDIC & SPORTS MEDICINE INSTITUTE OF LAS VEGAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Carol Randall
• Evonne Randall

• Orthopaedic Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Orthopaedic Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.