Active NPI
Jerry Lee Hunter, MD
- Family Medicine Physician
- Las Vegas, NV
National Provider Identifier
1306810155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5169
- Practice address
- 2300 W Charleston Blvd
Las Vegas, NV 89102 - Phone
- (702) 877-5319
- Fax
- (702) 259-0128
- NPI assigned
- Feb 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5169 | NV | Primary |
Addresses
Primary practice location
2300 W Charleston Blvd
Las Vegas, NV 89102
Mailing address
PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 242-7308
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2002584 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5169 | NV | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1306810155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15645",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891145645",
"telephone_number": "702-242-7308",
"fax_number": "702-240-8790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 W CHARLESTON BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89102",
"telephone_number": "702-877-5319",
"fax_number": "702-259-0128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNTER",
"first_name": "JERRY",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-16",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "5169",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2002584",
"state": "NV"
}
],
"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 Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.