NPIMap

Organization Active NPI

Forward Impressions, LLC

  • Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1295368041
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FORWARD IMPRESSIONS, LLC
Practice address
3650 N Rancho Dr Ste 109
Las Vegas, NV 89130-3151
Phone
(702) 848-1411
Fax
(702) 848-1711
NPI assigned
Feb 20, 2020
Organization subpart
Yes
Parent organization
FORWARD IMPRESSIONS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Authorized official

Name
Mrs. Charlene A DavisNPI 1023519709
Title
Authorized Official
Phone
(702) 469-1597

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3650 N Rancho Dr Ste 109
Las Vegas, NV 89130-3151

Mailing address

3650 N Rancho Dr Ste 109
Las Vegas, NV 89130-3151
Phone (702) 848-1411

National Provider Directory

National Provider Directory
Part of
Forward Impressions LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1295368041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 N RANCHO DR STE 109",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303151",
            "telephone_number": "702-848-1411",
            "fax_number": "702-848-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 N RANCHO DR STE 109",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303151",
            "telephone_number": "702-848-1411",
            "fax_number": "702-848-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORWARD IMPRESSIONS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORWARD IMPRESSIONS, LLC",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "702-469-1597",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "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 Mar 10, 2020; 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.