Nerve-US, LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

NERVE-US, LLC

Practice address

4743 Arapahoe Ave
Suite 202
Boulder, CO 80303-1113

Phone

(281) 324-5660

Fax

(281) 324-5679

NPI assigned

Dec 3, 2013

Organization subpart

No

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

Authorized official

Name

Mr. John Odem

Title

Member

Phone

(303) 507-8707

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1255762191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1288",
            "city": "CROSBY",
            "state": "TX",
            "postal_code": "775321288",
            "telephone_number": "281-324-5660",
            "fax_number": "281-324-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4743 ARAPAHOE AVE",
            "address_2": "SUITE 202",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031113",
            "telephone_number": "281-324-5660",
            "fax_number": "281-324-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NERVE-US, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-03",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "ODEM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "303-507-8707",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; 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.