NPIMap

Organization Active NPI

McLv2020 LLC

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1275398570
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MCLV2020 LLC
Practice address
1597 E Windmill LN
Las Vegas, NV 89123-1920
Phone
(702) 361-0125
NPI assigned
Feb 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Authorized official

Name
Jonathan Maxham, DONPI 1811124589
Title
Owner
Phone
(801) 660-0676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1597 E Windmill LN
Las Vegas, NV 89123-1920

Mailing address

2156 Fountain Springs Dr
Henderson, NV 89074-1576
Phone (801) 660-0676

National Provider Directory

National Provider Directory

Locations

1597 E Windmill Ln
Las Vegas, NV 89123
Phone (702) 361-0125

Practitioners & affiliated clinicians

Practitioners 2

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": "1707955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1275398570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 FOUNTAIN SPRINGS DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890741576",
            "telephone_number": "801-660-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1597 E WINDMILL LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891231920",
            "telephone_number": "702-361-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLV2020 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "MAXHAM",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-660-0676",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 15, 2024; 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.