NPIMap

Organization Active NPI

Absolute Primary Care Center

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1205265279
Registry record updated Apr 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3205 Issued in NV
Legal business name
ABSOLUTE PRIMARY CARE CENTER
Practice address
6857 W Charleston Blvd
Las Vegas, NV 89117-1600
Phone
(702) 885-7185
NPI assigned
Nov 10, 2013
Last updated
Apr 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2014

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

Authorized official

Name
Ms. Annie Mathew, DNP, APRNNPI 1346544061
Title
Director
Phone
(702) 885-7185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN001223 NV
Internal Medicine Physician 207R00000X 3205 NV Primary

Addresses

Primary practice location

6857 W Charleston Blvd
Las Vegas, NV 89117-1600

Mailing address

6857 W Charleston Blvd
Las Vegas, NV 89117-1600
Phone (702) 885-7185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140606000935 NV Part B Supplier - Clinic/Group Practice 3870717192 Receives reassigned benefits from 13 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

4218 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 425-5050

8064 W Sahara Ave
Ste 100
Las Vegas, NV 89117
Phone (702) 301-5575

3440 W Cheyenne Ave
Ste 100
North Las Vegas, NV 89032
Phone (702) 529-0059

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1384041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397952000000",
    "number": "1205265279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6857 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171600",
            "telephone_number": "702-885-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6857 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171600",
            "telephone_number": "702-885-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABSOLUTE PRIMARY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-10",
        "last_updated": "2014-04-20",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-885-7185",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN001223",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "3205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 20, 2014; 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.