Nu Wave Eswt, LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

NU WAVE ESWT, LLC

Practice address

4510 West Diablo Ave
Suite A110
Las Vegas, NV 89118

Phone

(702) 948-0604

NPI assigned

Feb 6, 2009

Last updated

Feb 6, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry Ballow

Title

Credentialing Specialist

Phone

(702) 202-3431

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1245479773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7365 PRAIRIE FALCON RD",
            "address_2": "SUITE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891282263",
            "telephone_number": "702-202-3431",
            "fax_number": "702-202-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 WEST DIABLO AVE",
            "address_2": "SUITE A110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89118",
            "telephone_number": "702-948-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NU WAVE ESWT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "BALLOW",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "702-202-3431"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pain Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; 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.