NPIMap

Organization Active NPI

Cca Direct Inc

Doing business as CCA Direct

  • Preferred Provider Organization
  • Las Vegas, NV
National Provider Identifier
1215715875
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
CCA DIRECT INC
Doing business as
CCA Direct
Practice address
6970 Obannon Dr
Las Vegas, NV 89117-2122
Phone
(619) 213-8147
NPI assigned
Sep 15, 2023
Last updated
Sep 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Authorized official

Name
Mr. Todd Steven Breeden
Title
Coo
Phone
(619) 213-8147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X NU Primary

Addresses

Primary practice location

6970 Obannon Dr
Las Vegas, NV 89117-2122

Mailing address

6970 Obannon Dr
Las Vegas, NV 89117-2122
Phone (619) 213-8147

Other names 1

  • CCA Direct Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1215715875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6970 OBANNON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172122",
            "telephone_number": "619-213-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6970 OBANNON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172122",
            "telephone_number": "619-213-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCA DIRECT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "BREEDEN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "619-213-8147",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCA Direct",
            "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 Sep 15, 2023; 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.