Active NPI
Reesa Stephanie Goravanchi, M.D.
- Obstetrics & Gynecology Physician
- Henderson, NV
National Provider Identifier
1306250972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 18136
- Practice address
- 650 S Green Valley Pkwy Ste 120
Henderson, NV 89052-0425 - Phone
- (702) 847-6252
- Fax
- (702) 847-6254
- NPI assigned
- Jun 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 18136 | NV | Primary |
Addresses
Primary practice location
650 S Green Valley Pkwy Ste 120
Henderson, NV 89052-0425
Mailing address
2011 Pinto LN Ste 200
Las Vegas, NV 89106-4007
Phone (702) 382-3200
Other practice location 1
2011 Pinto Ln Ste 200
Las Vegas, NV 89106-4007
Phone (702) 382-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100559246 | Medicaid | NV |
Other names 1
- Reesa Stephanie Child
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | eClinicalWorks | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
2011 Pinto LN
Suite 200
Las Vegas, NV 89106-4007
Phone (702) 382-3200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iriye Medical Group PLLC | Current | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Henderson Hospital | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Sunrise Hospital and Medical Center, LLC | Past | Accepting new patients |
Locations
2011 Pinto Ln
Ste 200
Las Vegas, NV 89106
Phone (702) 382-3200
Interoperability endpoints
- reesa.goravanchi.1@27017.direct.athenahealth.com
- https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4
Organizations & group practices 5
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.
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- General Acute Care Hospital
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1306250972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2011 PINTO LN STE 200",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064007",
"telephone_number": "702-382-3200",
"fax_number": "702-382-3575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 S GREEN VALLEY PKWY STE 120",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890520425",
"telephone_number": "702-847-6252",
"fax_number": "702-847-6254"
}
],
"practiceLocations": [
{
"address_1": "2011 Pinto Ln Ste 200",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891064007",
"country_code": "US",
"telephone_number": "702-382-3200",
"fax_number": "702-382-3575",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GORAVANCHI",
"first_name": "REESA",
"middle_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-11",
"last_updated": "2025-02-18",
"certification_date": "2025-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NV",
"license": "18136",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100559246",
"state": "NV"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "eClinicalWorks",
"affiliation": "N",
"endpointDescription": "EMR",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "EMR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "650 S Green Valley Pkwy Ste 120",
"city": "Henderson",
"state": "NV",
"country_code": "US",
"postal_code": "890520425",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "REESA",
"last_name": "CHILD",
"middle_name": "STEPHANIE",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}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 Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.