NPIMap

Organization Active NPI

Innotiv Germin

Doing business as Clinical Neurology Specialists

  • Neurology Physician
  • Henderson, NV
National Provider Identifier
1225101330
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
7866 Issued in NV
Legal business name
INNOTIV GERMIN
Doing business as
Clinical Neurology Specialists
Practice address
1691 W Horizon Ridge Pkwy
#100
Henderson, NV 89012-3494
Phone
(702) 804-1212
Fax
(702) 804-1222
NPI assigned
Nov 16, 2006
Last updated
Jan 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Authorized official

Name
Mr. Leo Germin, M.D.NPI 1013928886
Title
Medical Director
Phone
(702) 804-1212

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
Neurology Physician 2084N0400X 7866 NV Primary

Addresses

Primary practice location

1691 W Horizon Ridge Pkwy
#100
Henderson, NV 89012-3494

Mailing address

PO Box 530786
Henderson, NV 89053-0786
Phone (702) 804-1212

Other identifiers 1

IdentifierTypeStateIssuer
002019758MedicaidNV

Other names 1

  • Clinical Neurology Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160627000281 NV Part B Supplier - Clinic/Group Practice 3476844259 Receives reassigned benefits from 7 practitioners
Practice locations: Henderson, NV

National Provider Directory

National Provider Directory

Locations

1691 W Horizon Ridge Pkwy
Henderson, NV 89012
Phone (702) 804-1212

1691 W Horizon Ridge Pkwy
Ste 100
Henderson, NV 89012
Phone (702) 450-8485

1321 S Rainbow Blvd
Las Vegas, NV 89146
Phone (702) 804-6555

7751 W Flamingo Rd
Ste A100
Las Vegas, NV 89147
Phone (702) 804-6555

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453248000000",
    "number": "1225101330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530786",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890530786",
            "telephone_number": "702-804-1212",
            "fax_number": "702-804-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 W HORIZON RIDGE PKWY",
            "address_2": "#100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890123494",
            "telephone_number": "702-804-1212",
            "fax_number": "702-804-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOTIV GERMIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2016-01-20",
        "status": "A",
        "authorized_official_last_name": "GERMIN",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-804-1212",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NV",
            "license": "7866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019758",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Neurology Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.