Individualized Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

8025 Issued in NV

Legal business name

INDIVIDUALIZED INTERNAL MEDICINE

Practice address

8463 W Lake Mead Blvd
Las Vegas, NV 89128-7638

Phone

(702) 304-0854

Fax

(702) 256-2821

NPI assigned

Oct 30, 2014

Organization subpart

No

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

Authorized official

Name

Shamini K PanikkarNPI 1508898768

Title

Owner & Provider

Phone

(702) 304-0854

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shamini K Panikkar, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1508898768
  Medicare reassignment NPD Authorized official
• Robert K White, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1740208834
  NPD (past)

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768780800000",
    "number": "1194120253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8463 W LAKE MEAD BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287638",
            "telephone_number": "702-304-0854",
            "fax_number": "702-256-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8463 W LAKE MEAD BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287638",
            "telephone_number": "702-304-0854",
            "fax_number": "702-256-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUALIZED INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A",
        "authorized_official_last_name": "PANIKKAR",
        "authorized_official_first_name": "SHAMINI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER & PROVIDER",
        "authorized_official_telephone_number": "702-304-0854"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "8025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indigo Pharmaceutical LLC
• Indigo Supportive Services LLC.
• Indigo Wellness (Indigo Wellness Center)
• Indigo-Bane LLC (lo-go-pae-dics)
• Individual
• Individualized Mindful Solutions LLC
• Priscilla Indome
• Daniel Indorato, M.D.
• Christopher Indrieri
• Joseph Indrieri, DPT

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.