Organization Active NPI

Las Vegas Wound Care Clinic LLC

  • Wound Care Registered Nurse
  • Las Vegas, NV
National Provider Identifier
1326883174
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
Legal business name
LAS VEGAS WOUND CARE CLINIC LLC
Practice address
2855 S Bronco St
Las Vegas, NV 89146-5207
Phone
(470) 363-3311
NPI assigned
Jun 25, 2024
Last updated
Jun 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Edsel Iway, MDNPI 1093097735
Title
Provider
Phone
(470) 363-3311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

2855 S Bronco St
Las Vegas, NV 89146-5207

Mailing address

2855 S Bronco St
Las Vegas, NV 89146-5207

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1326883174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 S BRONCO ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 S BRONCO ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465207",
            "telephone_number": "470-363-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS WOUND CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "IWAY",
        "authorized_official_first_name": "EDSEL",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "470-363-3311",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jun 25, 2024; 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.