NPIMap

Organization Active NPI

Intermountain Medical Holdings Nevada Inc

Doing business as Intermountain Health

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1245997279
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC
Doing business as
Intermountain Health
Practice address
595 W Lake Mead Pkwy
Henderson, NV 89015-7015
Phone
(702) 566-5500
NPI assigned
Nov 24, 2021
Last updated
Nov 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Mitch Cloward
Title
Nevada Region President
Phone
(702) 216-3346

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU
Hematology & Oncology Physician 207RH0003X NU
Interventional Cardiology Physician 207RI0011X NU
Medical Oncology Physician 207RX0202X NU
Nuclear Cardiology Physician 207UN0901X NU
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X NU
Radiation Oncology Physician 2085R0001X NU
Hospitalist Physician 208M00000X NU
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X NU

Addresses

Primary practice location

595 W Lake Mead Pkwy
Henderson, NV 89015-7015

Mailing address

6355 S Buffalo Dr
Las Vegas, NV 89113-2133
Phone (702) 580-1323

Other names 1

  • Intermountain Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220214001765 NV Part B Supplier - Clinic/Group Practice 7416054622 Receives reassigned benefits from 540 practitioners

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D0921337Intermountain Health - W Lake Mead595 W Lake Mead Pkwy, Henderson, NV 89015Certificate of waiverOct 23, 2026
29D1101124Intermountain Health - West Lake Mead -595 W Lake Mead Pkwy, Henderson, NV 89015Certificate of waiverJun 18, 2027

National Provider Directory

National Provider Directory

Locations

1297 Boulder City Pkwy
Ste A
Boulder City, NV 89005
Phone (702) 294-1919

1397 Galleria Dr
Ste 100
Henderson, NV 89014
Phone (702) 436-5800

1505 Wigwam Pkwy
Ste 230
Henderson, NV 89074
Phone (702) 562-8900

2350 Corporate Cir
Ste 101
Henderson, NV 89074
Phone (702) 938-0088

2825 Siena Heights Dr
Ste 101
Henderson, NV 89052
Phone (702) 616-7049

2825 Siena Heights Dr
Ste 102
Henderson, NV 89052
Phone (702) 940-1535

2891 N Green Valley Pkwy
Henderson, NV 89014
Phone (702) 948-1140

10040 Alta Dr
Ste 350
Las Vegas, NV 89145
Phone (702) 360-7600

1700 N Buffalo Dr
Ste 100
Las Vegas, NV 89128
Phone (702) 233-8855

2880 N Tenaya Way
Fl 3
Las Vegas, NV 89128
Phone (702) 427-9587

321 N Nellis Blvd
Ste 110
Las Vegas, NV 89110
Phone (702) 438-4003

5320 S Rainbow Blvd
Ste 182
Las Vegas, NV 89118
Phone (702) 304-5722

821 N Nellis Blvd
Ste 100
Las Vegas, NV 89110
Phone (702) 438-4003

8595 S Decatur Blvd
Ste 108
Las Vegas, NV 89139
Phone (702) 948-1130

9260 W Sunset Rd
Ste 100
Las Vegas, NV 89148
Phone (702) 534-5464

1302 W Craig Rd
Ste A
North Las Vegas, NV 89032
Phone (702) 473-8380

2055 E Cheyenne Ave
North Las Vegas, NV 89030
Phone (702) 852-9010

Practitioners & affiliated clinicians

Practitioners 729

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.

View all 729

NPI Registry JSON

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1245997279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-580-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 W LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157015",
            "telephone_number": "702-566-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-24",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "CLOWARD",
        "authorized_official_first_name": "MITCH",
        "authorized_official_title_or_position": "NEVADA REGION PRESIDENT",
        "authorized_official_telephone_number": "702-216-3346"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.

Verify at the official NPI Registry.