Individual provider Active NPI

Laura D Addis, D.O.

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1316010895
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1216 Issued in NV
Practice address
390 W Lake Mead Pkwy Ste 120
Henderson, NV 89015-7417
Phone
(725) 220-8477
Fax
(833) 749-0360
NPI assigned
Nov 15, 2006
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1216 NV Primary

Addresses

Primary practice location

390 W Lake Mead Pkwy Ste 120
Henderson, NV 89015-7417

Mailing address

390 W Lake Mead Pkwy Ste 120
Henderson, NV 89015-7417
Phone (725) 220-8477

Other identifiers 1

IdentifierTypeStateIssuer
1316010895MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address laura.addis@centerwell.eclinicaldirectplus.com Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050705000427 NV Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 3870539596 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

301 N Pecos Rd
Suite E
Henderson, NV 89074-1350
Phone (725) 200-4391

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1216NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Nevada Asplin PC Internal Medicine CurrentSince Nov 14, 2022 Accepting new patients
Healthcare Partners Medical Group Coats LTD Internal Medicine Current Accepting new patients
Dana Forte D O LTD Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Addis Advanced Medical Associates LLC Internal Medicine CurrentSince May 31, 2024 Accepting new patients
Intermountain Medical Holdings Nevada Inc Internal Medicine Past Accepting new patients
Wolfson & Wolfson LLP PastSince Oct 1, 2019 Accepting new patients
Qazi Makhija & Barney LLP PastSince Oct 1, 2019 Accepting new patients
Albion Medical Group of Nevada, PC Internal Medicine PastSince Feb 1, 2012 Accepting new patients
Physicians Medical Center Kaufman, LTD Past Accepting new patients

Locations

301 N Pecos Rd
Ste E
Henderson, NV 89074
Phone (702) 326-5996

601 S Green Valley Pkwy
Henderson, NV 89052
Phone (702) 896-2956

2481 Professional Ct
Las Vegas, NV 89128
Phone (702) 213-8253

4845 S Rainbow Blvd
Ste 402
Las Vegas, NV 89103
Phone (702) 362-9800

9010 W Cheyenne Ave
Las Vegas, NV 89129
Phone (702) 240-8646

Interoperability endpoints

  • Direct secure messaging: laura.addis.1@31526.direct.athenahealth.com
  • Direct secure messaging: laura.addis@centerwell.eclinicaldirectplus.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1316010895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 W LAKE MEAD PKWY STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157417",
            "telephone_number": "725-220-8477",
            "fax_number": "833-749-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 W LAKE MEAD PKWY STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157417",
            "telephone_number": "725-220-8477",
            "fax_number": "833-749-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDIS",
        "first_name": "LAURA",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "1216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316010895",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laura.addis@centerwell.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "390 W Lake Mead Pkwy Ste 120",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890157417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.