Havoc City Boxing and Fitness

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

HAVOC CITY BOXING AND FITNESS

Doing business as

Havoc City Boxing and fitness

Practice address

9890 S Maryland Pkwy
Las Vegas, NV 89183-7166

Phone

(702) 588-3409

NPI assigned

Sep 29, 2017

Organization subpart

No

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

Authorized official

Name

Brandon D Harris

Title

Opm

Phone

(702) 588-3409

Specialties & licenses 1

Addresses

Other names 1

• Havoc City Boxing and fitness Doing business as

Locations

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506643200000",
    "number": "1346750676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 SABATINI DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524127",
            "telephone_number": "702-588-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9890 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837166",
            "telephone_number": "702-588-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVOC CITY BOXING AND FITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OPM",
        "authorized_official_telephone_number": "702-588-3409"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Havoc City Boxing and fitness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anthony S Haverstock
• Elizabeth Mary Haviland, NURSE PRACTITIONER
• John Paul Havill, MBBS
• Laura Katherine Havins, MSN, FNP-BC, APRN
• Brooke Havis
• Herbert L. Hawes Jr., MD
• Ashonta Amber Hawk
• Kristin Hawk, DPT
• Steven Hawkes, PA
• Viktoriya Hawkes

• Health Maintenance Organization in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Health Maintenance Organization in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.