Las Vegas Kidney Clinic Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

3221ESR3 Issued in NV

Legal business name

LAS VEGAS KIDNEY CLINIC INC.

Practice address

1905 Civic Center Dr
Ste 201
North Las Vegas, NV 89030-7116

Phone

(702) 214-9516

Fax

(702) 214-9415

NPI assigned

Jun 8, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Galen Robert Bennett, BSBA

Title

Administrator

Phone

(702) 214-9516

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Rachakonda D Prabhu, M.D.

  • Pulmonary Disease Physician
  • Las Vegas, NV
  • NPI 1538156633
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1245234145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 CIVIC CENTER DR",
            "address_2": "STE 201",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307116",
            "telephone_number": "702-214-9516",
            "fax_number": "702-214-9415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CIVIC CENTER DR",
            "address_2": "STE 201",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307116",
            "telephone_number": "702-214-9516",
            "fax_number": "702-214-9415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS KIDNEY CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "GALEN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-214-9516",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSBA"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NV",
            "license": "3221ESR3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100501915",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriela Hortencia Larios Bello
• Blanca Hilda Larios
• Laura Elena Larralde-Ychuste
• Naniko Dionne Larry, PHARM.D.
• Tiffany Larsen, OTD/S
• Las Vegas Mental Health Services
• Las Vegas NV Opco LLC
• Las Vegas Rheumatology Associates
• Las Vegas Vamc
• Las Vegas Vamc

• Medical Specialty Clinic/Center in North Las Vegas, NV
• Providers in North 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 Jun 6, 2008; 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.