NPIMap

Organization Active NPI

Board of Regents Nevada System of Higher Education

Doing business as UNLV Ackerman Center for Autism and Neurodeveloment Solutions

  • Developmental - Behavioral Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1295288553
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
Legal business name
BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION
Doing business as
UNLV Ackerman Center for Autism and Neurodeveloment Solutions
Practice address
630 S. Rancho, Ste. a
Las Vegas, NV 89106
Phone
(702) 998-9505
NPI assigned
Aug 3, 2016
Last updated
Aug 3, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Authorized official

Name
Tracey Green, M.D.
Title
Vice Dean of Clinical Affairs
Phone
(702) 998-9505

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NU
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU
Adolescent Medicine (Internal Medicine) Physician 207RA0000X NU
Clinical Genetics (M.D.) Physician 207SG0201X NU
Pediatric Adolescent Medicine Physician 2080A0000X NU
Developmental - Behavioral Pediatrics Physician 2080P0006X NU Primary
Child & Adolescent Psychiatry Physician 2084P0804X NU
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X NU
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

630 S. Rancho, Ste. a
Las Vegas, NV 89106

Mailing address

630 S. Rancho, Ste. a
Las Vegas, NV 89106
Phone (702) 998-9505

Other names 1

  • UNLV Ackerman Center for Autism and Neurodeveloment Solutions Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Board of Regents Uccsn U of NV26 organizations share this tax ID, including this one
Part of
Board of Regents Uccsn U of NV

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1295288553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S. RANCHO, STE. A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "telephone_number": "702-998-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S. RANCHO, STE. A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "telephone_number": "702-998-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "VICE DEAN OF CLINICAL AFFAIRS",
        "authorized_official_telephone_number": "702-998-9505",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNLV Ackerman Center for Autism and Neurodeveloment Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 3, 2016; 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.