Las Vegas Wound Care Clinic LLC

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

Organization subpart

No

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

Authorized official

Name

Edsel Iway, MD

Title

Provider

Phone

(470) 363-3311

Specialties & licenses 2

Addresses

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": []
}

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• Wound Care Registered Nurse in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Wound Care Registered Nurse in Nevada

• 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.