NPIMap

Organization Active NPI

Southern Nevada Health District

  • Clinical Medical Laboratory
  • Las Vegas, NV
National Provider Identifier
1215315973
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
3828PHL-7 Issued in NV
Legal business name
SOUTHERN NEVADA HEALTH DISTRICT
Practice address
700 S Martin Luther King Blvd
Las Vegas, NV 89106-4409
Phone
(702) 759-1000
NPI assigned
May 14, 2015
Organization subpart
Yes
Parent organization
SOUTHERN NEVADA PUBLIC HEALTH LABORATORYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Donna Buss
Title
Revenue Cycle Manager
Phone
(702) 759-0636

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 3828PHL-7 NV Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

700 S Martin Luther King Blvd
Las Vegas, NV 89106-4409

Mailing address

P O Box 3902
Las Vegas, NV 89127
Phone (702) 759-1000

Other practice location 1

700 Desert Lane
Las Vegas, NV 89106
Phone (702) 759-1020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wilsonc@snhd.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160915000735 NV Part B Supplier - Independent Clinical Laboratory 3375542939 1 other NPI on this enrollment
Practice locations: Las Vegas, NV

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D1027844Southern Nevada Public Health Laboratory700 S Martin L King Blvd, Las Vegas, NV 89106ComplianceApr 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Southern Nevada Health District Pharmacy5 organizations share this tax ID, including this one
Part of
Southern Nevada Health District Pharmacy

Other organizations with this tax ID 4

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

Locations

700 S Martin L King Blvd
Las Vegas, NV 89106
Phone (702) 759-1000

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southern Neveda Community Health CenterLas Vegas, NV, CCN 291867 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 3, 1978

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1215315973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 3902",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89127",
            "telephone_number": "702-759-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S MARTIN LUTHER KING BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064409",
            "telephone_number": "702-759-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 DESERT LANE",
            "address_purpose": "LOCATION",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "country_code": "US",
            "telephone_number": "702-759-1020",
            "fax_number": "702-759-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN NEVADA HEALTH DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN NEVADA PUBLIC HEALTH LABORATORY",
        "enumeration_date": "2015-05-14",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "BUSS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "702-759-0636"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NV",
            "license": "3828PHL-7",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wilsonc@snhd.org",
            "affiliation": "N",
            "address_1": "700 S Martin Luther King Blvd",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891064409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.