NPIMap

Organization Active NPI

Southern Nevada Care Center

Doing business as Southern Nevada Medical and Behavioral Group

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Las Vegas, NV
National Provider Identifier
1205563863
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
SOUTHERN NEVADA CARE CENTER
Doing business as
Southern Nevada Medical and Behavioral Group
Practice address
1330 Karen Ave Unit B
Las Vegas, NV 89169-1260
Phone
(702) 625-0022
NPI assigned
Aug 4, 2022
Last updated
Aug 4, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN NEVADA CARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Authorized official

Name
Marichu Pizan, NPNPI 1497131668
Title
Ceo
Phone
(702) 800-5393

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

1330 Karen Ave Unit B
Las Vegas, NV 89169-1260

Mailing address

1330 Karen Ave Unit B
Las Vegas, NV 89169-1260
Phone (702) 625-0022

Other identifiers 1

IdentifierTypeStateIssuer
1801485131MedicaidNV

Other names 1

  • Southern Nevada Medical and Behavioral Group Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL office Direct

National Provider Directory

National Provider Directory
Tax ID family
Southern Nevada Care Center3 organizations share this tax ID, including this one
Part of
Southern Nevada Care Center

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1205563863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 KAREN AVE UNIT B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891691260",
            "telephone_number": "702-625-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 KAREN AVE UNIT B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891691260",
            "telephone_number": "702-625-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN NEVADA CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN NEVADA CARE CENTER",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "PIZAN",
        "authorized_official_first_name": "MARICHU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-800-5393",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801485131",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office",
            "affiliation": "N",
            "endpointDescription": "separate room",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1330 Karen Ave Unit B",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891691260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Southern Nevada Medical and Behavioral Group",
            "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 4, 2022; 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.