NPIMap

Organization Active NPI

Dignity Health Medical Group Nevada LLC

  • Family Medicine Physician
  • Henderson, NV
National Provider Identifier
1295244929
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DIGNITY HEALTH MEDICAL GROUP NEVADA LLC
Practice address
800 N Gibson Rd Ste 101
Henderson, NV 89011-1706
Phone
(702) 616-5801
NPI assigned
Sep 26, 2017
Last updated
Sep 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Authorized official

Name
Melissa Walker
Title
Cfo
Phone
(702) 616-5507

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

800 N Gibson Rd Ste 101
Henderson, NV 89011-1706

Mailing address

2200 Paseo Verde Pkwy Ste 260
Henderson, NV 89052-2703

National Provider Directory

National Provider Directory
Tax ID family
Dignity Health Medical Group Nevada LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

2200 Paseo Verde Pkwy
Ste 260
Henderson, NV 89052

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506384000000",
    "number": "1295244929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PASEO VERDE PKWY STE 260",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N GIBSON RD STE 101",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890111706",
            "telephone_number": "702-616-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGNITY HEALTH MEDICAL GROUP NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "702-616-5507"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.