Active NPI
Modern Wellness Clinic, LLC
Doing business as Modern Wellness Clinic
- Family Medicine Physician
- Las Vegas, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MODERN WELLNESS CLINIC, LLC
- Doing business as
- Modern Wellness Clinic
- Practice address
- 5375 S Fort Apache Rd
Las Vegas, NV 89148-7623 - Phone
- (702) 463-9159
- NPI assigned
- Jul 9, 2021
- Last updated
- Apr 20, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert J Webb, PA
- Title
- Managing Parner
- Phone
- (702) 236-7171
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Infectious Disease Physician | 207RI0200X | |||
| Psychiatry Physician | 2084P0800X |
Addresses
Primary practice location
5375 S Fort Apache Rd
Las Vegas, NV 89148-7623
Mailing address
5375 S Fort Apache Rd
Las Vegas, NV 89148-7623
Other practice location 1
3115 S Eastern Ave
Las Vegas, NV 89169-3308
Phone (702) 463-9159
Other names 1
- Modern Wellness Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D2241417 | Modern Wellness Clinic | Certificate of waiver | Oct 27, 2027 |
National Provider Directory
National Provider DirectoryLocations
5375 S Fort Apache Rd
Las Vegas, NV 89148
Phone (702) 253-6888
Practitioners & affiliated clinicians
Practitioners 7
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.
-
- Physician Assistant
- Las Vegas, NV
- NPI 1154412385
-
- Addiction Medicine (Psychiatry & Neurology) Physician
- Las Vegas, NV
- NPI 1013085257
-
- Family Nurse Practitioner
- Las Vegas, NV
- NPI 1871128983
-
- Physician Assistant
- Las Vegas, NV
- NPI 1457997793
-
- Infectious Disease Physician
- Las Vegas, NV
- NPI 1457519332
-
- Internal Medicine Physician
- North Las Vegas, NV
- NPI 1821033879
-
- Family Nurse Practitioner
- Las Vegas, NV
- NPI 1306451240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625788800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776643200000",
"number": "1245801273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5375 S FORT APACHE RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891487623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5375 S FORT APACHE RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891487623",
"telephone_number": "702-463-9159"
}
],
"practiceLocations": [
{
"address_1": "3115 S Eastern Ave",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891693308",
"country_code": "US",
"telephone_number": "702-463-9159",
"fax_number": "702-463-6611",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MODERN WELLNESS CLINIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-07-09",
"last_updated": "2026-04-20",
"certification_date": "2026-04-20",
"status": "A",
"authorized_official_last_name": "WEBB",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "MANAGING PARNER",
"authorized_official_telephone_number": "702-236-7171",
"authorized_official_credential": "PA"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RI0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Modern Wellness Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Modern Wellness Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.