NPIMap

Organization Active NPI

Fremont Primary Care - Endocrinology

  • Metabolic Nutrition Registered Dietitian
  • Las Vegas, NV
National Provider Identifier
1295712693
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
Legal business name
FREMONT PRIMARY CARE - ENDOCRINOLOGY
Practice address
4880 Wynn Rd
Las Vegas, NV 89103-5406
Phone
(702) 362-3422
Fax
(702) 939-8827
NPI assigned
Dec 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Jon Greg Griffin
Title
Ceo
Phone
(702) 671-6800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133V00000X
Metabolic Nutrition Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133VN1006X Primary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RE0101X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

4880 Wynn Rd
Las Vegas, NV 89103-5406

Mailing address

PO Box 1737
Las Vegas, NV 89125-1737
Phone (702) 671-6800

Other names 1

  • Joslin Diabetes Center Affiliate at Fremont Medical Center Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1295712693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1737",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891251737",
            "telephone_number": "702-671-6800",
            "fax_number": "702-671-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 WYNN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035406",
            "telephone_number": "702-362-3422",
            "fax_number": "702-939-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT PRIMARY CARE - ENDOCRINOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "GREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-671-6800"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joslin Diabetes Center Affiliate at Fremont Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 11, 2025; 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.