NPIMap

Organization Active NPI

Ackerman Autism Center, LLC

  • Developmental - Behavioral Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1306416433
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
Legal business name
ACKERMAN AUTISM CENTER, LLC
Practice address
630 S Rancho Dr Ste a
Las Vegas, NV 89106-4849
Phone
(702) 844-4579
NPI assigned
Jun 30, 2021
Last updated
Jun 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Authorized official

Name
Brian Hager
Title
Executive Director
Phone
(702) 844-4579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X NU Primary

Addresses

Primary practice location

630 S Rancho Dr Ste a
Las Vegas, NV 89106-4849

Mailing address

630 S Rancho Dr Ste a
Las Vegas, NV 89106-4849
Phone (702) 844-4579

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.grantagiftfoundation.org Other

National Provider Directory

National Provider Directory
Tax ID family
Ackerman Autism Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

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

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1306416433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S RANCHO DR STE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064849",
            "telephone_number": "702-844-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S RANCHO DR STE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064849",
            "telephone_number": "702-844-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACKERMAN AUTISM CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "HAGER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "702-844-4579"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.grantagiftfoundation.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Web address",
            "address_1": "630 S Rancho Dr Ste A",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891064849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jun 30, 2021; 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.