Active NPI
Allen Alva Erisman, D.O.
- Emergency Medicine Physician
- Las Vegas, NV
National Provider Identifier
1245233485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 1135
- Practice address
- 3100 N Tenaya Way
Las Vegas, NV 89128-0436 - Phone
- (972) 915-3600
- Fax
- (972) 915-3636
- NPI assigned
- May 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 1135 | NV | Primary |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 1135 | NV | |
| Emergency Medicine Physician | 207P00000X | 02002084A | IN |
Addresses
Primary practice location
3100 N Tenaya Way
Las Vegas, NV 89128-0436
Mailing address
9229 LBJ Fwy
Ste 250
Dallas, TX 75243-3405
Phone (800) 346-0747
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CC7823 | Other | NV | BCBS |
| 100502406 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Webster Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1851339998
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412121600000",
"number": "1245233485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9229 LBJ FWY",
"address_2": "STE 250",
"city": "DALLAS",
"state": "TX",
"postal_code": "752433405",
"telephone_number": "800-346-0747",
"fax_number": "972-739-2638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 N TENAYA WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280436",
"telephone_number": "972-915-3600",
"fax_number": "972-915-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERISMAN",
"first_name": "ALLEN",
"middle_name": "ALVA",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-23",
"last_updated": "2014-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NV",
"license": "1135",
"primary": true
},
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "NV",
"license": "1135",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "02002084A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "CC7823",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100502406",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}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 Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.