Endeavors Medical Group Corp.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

ENDEAVORS MEDICAL GROUP CORP.

Practice address

2700 E Sunset Rd Ste 13
Las Vegas, NV 89120-3508

Phone

(310) 848-8865

NPI assigned

Dec 7, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Eden Dabalus, FNP-C

Title

FNP-C/ Ceo

Phone

(702) 891-0026

Specialties & licenses 3

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1225634157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 E SUNSET RD STE 13",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203508",
            "telephone_number": "702-891-0026",
            "fax_number": "702-895-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E SUNSET RD STE 13",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203508",
            "telephone_number": "310-848-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVORS MEDICAL GROUP CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "DABALUS",
        "authorized_official_first_name": "EDEN",
        "authorized_official_title_or_position": "FNP-C/ CEO",
        "authorized_official_telephone_number": "702-891-0026",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "2700 E Sunset Rd Ste 13",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891203508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Medical Specialty Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.