NPIMap

Organization Active NPI

Fremont Women's Health, LLC

  • Obstetrics & Gynecology Physician
  • Las Vegas, NV
National Provider Identifier
1255318648
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
FREMONT WOMEN'S HEALTH, LLC
Practice address
3196 S Maryland Pkwy
Suite 303
Las Vegas, NV 89109-2305
Phone
(702) 383-2919
Fax
(702) 383-2886
NPI assigned
Dec 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Authorized official

Name
Jon Greg Griffin
Title
Ceo
Phone
(702) 671-6800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X Primary
Sonography Radiologic TechnologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2471S1302X
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X
Obstetrics & Gynecology Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LX0001X

Addresses

Primary practice location

3196 S Maryland Pkwy
Suite 303
Las Vegas, NV 89109-2305

Mailing address

PO Box 612
Las Vegas, NV 89125-0612
Phone (702) 671-6800

Other identifiers 1

IdentifierTypeStateIssuer
100501006MedicaidNV

Other names 1

  • Fremont Womens Health Care Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Fremont Women's Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

500 S Rancho Dr
Ste A3
Las Vegas, NV 89106
Phone (702) 870-2939

500 S Rancho Dr
Las Vegas, NV 89106

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1255318648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 612",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891250612",
            "telephone_number": "702-671-6800",
            "fax_number": "702-671-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3196 S MARYLAND PKWY",
            "address_2": "SUITE 303",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092305",
            "telephone_number": "702-383-2919",
            "fax_number": "702-383-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT WOMEN'S HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "GREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-671-6800"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100501006",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fremont Womens Health Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 15, 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.