NPIMap

Individual provider Active NPI

Julian Armand Davis

  • Prosthetics Case Management
  • North Las Vegas, NV
National Provider Identifier
1275069361
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
C-34997 Issued in NV
Practice address
5710 Simmons St
North Las Vegas, NV 89031-9900
Phone
(702) 721-8863
NPI assigned
May 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X 1704450989 NV
Prosthetics Case Management 1744P3200X C-34997 NV Primary

Addresses

Primary practice location

5710 Simmons St
North Las Vegas, NV 89031-9900

Mailing address

5575 Simmons St
Suite 1-174
North Las Vegas, NV 89031-9009
Phone (702) 721-8863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1704450989NVMDProsthetics Case Management
C-34997NVMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1275069361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 SIMMONS ST",
            "address_2": "SUITE 1-174",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890319009",
            "telephone_number": "702-721-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 SIMMONS ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890319900",
            "telephone_number": "702-721-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JULIAN",
        "middle_name": "ARMAND",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "NV",
            "license": "1704450989",
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "NV",
            "license": "C-34997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.