NPIMap

Organization Active NPI

Love Your Body Medical Spa

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1194949131
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7308 Issued in NV
Legal business name
LOVE YOUR BODY MEDICAL SPA
Practice address
5693 S Jones Blvd
Ste 108
Las Vegas, NV 89118-1965
Phone
(702) 649-5683
Fax
(702) 222-3683
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Divina A Obena, MD
Title
Physician
Phone
(702) 649-5683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 7308 NV Primary

Addresses

Primary practice location

5693 S Jones Blvd
Ste 108
Las Vegas, NV 89118-1965

Mailing address

5693 S Jones Blvd
Ste 108
Las Vegas, NV 89118-1965
Phone (702) 649-5683

Other names 1

  • NONE Doing business as

National Provider Directory

National Provider Directory

Locations

5693 S Jones Blvd
Ste 108
Las Vegas, NV 89118
Phone (702) 649-5683

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194949131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5693 S JONES BLVD",
            "address_2": "STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181965",
            "telephone_number": "702-649-5683",
            "fax_number": "702-222-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5693 S JONES BLVD",
            "address_2": "STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181965",
            "telephone_number": "702-649-5683",
            "fax_number": "702-222-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVE YOUR BODY MEDICAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OBENA",
        "authorized_official_first_name": "DIVINA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "702-649-5683",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NV",
            "license": "7308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NONE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • 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.