Queensridge Cardiology Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

QUEENSRIDGE CARDIOLOGY CENTER LLC

Practice address

10040 Alta Drive
Suite 250
Las Vegas, NV 89145-8905

Phone

(702) 589-9250

Fax

(702) 589-9257

NPI assigned

Aug 12, 2022

Organization subpart

No

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

Authorized official

Name

Robert Lerma, MS,MBA,CASC

Title

Administrator

Phone

(702) 589-9250

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• QUEENSRIDGE CARDIOLOGY CENTER LLC Doing business as

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1205564663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2779 W HORIZON RIDGE PKWY STE 140",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524186",
            "telephone_number": "702-589-9250",
            "fax_number": "702-589-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10040 ALTA DRIVE",
            "address_2": "SUITE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891458905",
            "telephone_number": "702-589-9250",
            "fax_number": "702-589-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENSRIDGE CARDIOLOGY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "LERMA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-589-9250",
        "authorized_official_credential": "MS,MBA,CASC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL PAYRORS",
            "identifier": "1043652906",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QUEENSRIDGE CARDIOLOGY CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chanel Queen
• Doris Ann Queen
• Kaelani Maj Queen
• Linda Marie Queen
• Michael Queensborough
• Queensridge Surgery Center
• Ashton-Travis Queja, DMD
• James Quenzler
• Rosaline Elizabeth Quero
• Rey Anthony Querol, RN

• Ambulatory Surgical Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.