Biomatrix Advanced Graft Solutions LTD

Primary specialty

Wound Care Registered NurseTaxonomy code 163WW0000X

Legal business name

BIOMATRIX ADVANCED GRAFT SOLUTIONS LTD

Practice address

3305 Spring Mountain Rd Ste 86
Las Vegas, NV 89102-8630

Phone

(702) 635-7443

NPI assigned

Jan 14, 2025

Organization subpart

No

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

Authorized official

Name

Beverly Thielke, NURSE PRACTITIONER

Title

Provider

Phone

(702) 635-7443

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1255142808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 SPRING MOUNTAIN RD STE 86",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891028630",
            "telephone_number": "702-635-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 SPRING MOUNTAIN RD STE 86",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891028630",
            "telephone_number": "702-635-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOMATRIX ADVANCED GRAFT SOLUTIONS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "THIELKE",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "702-635-7443",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wound Care Registered Nurse in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Wound Care Registered Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.