NPIMap

Individual provider Active NPI

Georgina Emily Grant, MD

  • Emergency Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1295294304
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21997 Issued in NV
Practice address
500 N Rainbow Blvd Ste 203
Las Vegas, NV 89107-1084
Phone
(702) 259-1228
Fax
(702) 259-1252
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21997 NV Primary

Addresses

Primary practice location

500 N Rainbow Blvd Ste 203
Las Vegas, NV 89107-1084

Mailing address

500 N Rainbow Blvd Ste 203
Las Vegas, NV 89107-1084
Phone (702) 259-1228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220906002983 NV Practitioner - Emergency Medicine 8426444647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (954) 939-5000

Hospital & facility affiliations

  • Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290021
  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054
  • Henderson Hospital Hospital, Henderson, NV, CCN 290057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21997NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Jun 21, 2022 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Jun 21, 2022 Accepting new patients
Doctors Medical Services, Emcare PastSince Aug 14, 2022 Accepting new patients

Locations

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1295294304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071084",
            "telephone_number": "702-259-1228",
            "fax_number": "702-259-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071084",
            "telephone_number": "702-259-1228",
            "fax_number": "702-259-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "GEORGINA",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "21997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.