Organization Active NPI

Kraft Center for Pain Control, LLC

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1346458239
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
58853 Issued in NV
Legal business name
KRAFT CENTER FOR PAIN CONTROL, LLC
Practice address
2650 Crimson Canyon Dr
Las Vegas, NV 89128-0841
Phone
(702) 731-2642
Fax
(702) 791-2070
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Debra Ford
Title
Manager
Phone
(702) 731-2642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 58853 NV Primary

Addresses

Primary practice location

2650 Crimson Canyon Dr
Las Vegas, NV 89128-0841

Mailing address

2650 Crimson Canyon Dr
Las Vegas, NV 89128-0841
Phone (702) 731-2642

Other names 1

  • Advanced Pain Consultants Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040707001308 NV Part B Supplier - Clinic/Group Practice 3173501186 Receives reassigned benefits from 4 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

1701 N Green Valley Pkwy
Bldg 2
Henderson, NV 89074

2650 Crimson Canyon Dr
Las Vegas, NV 89128
Phone (702) 731-2642

2080 E Flamingo Rd
Ste 309
Las Vegas, NV 89119
Phone (702) 731-2642

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1346458239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 CRIMSON CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280841",
            "telephone_number": "702-731-2642",
            "fax_number": "702-791-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 CRIMSON CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280841",
            "telephone_number": "702-731-2642",
            "fax_number": "702-791-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRAFT CENTER FOR PAIN CONTROL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-731-2642"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NV",
            "license": "58853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Pain Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.