Organization Active NPI

Zephyrene C Villaluz MD CHTD

  • Family Medicine Physician
  • N Las Vegas, NV
National Provider Identifier
1356415616
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6679 Issued in NV
Legal business name
ZEPHYRENE C VILLALUZ MD CHTD
Practice address
1825 Civic Center Drive
N Las Vegas, NV 89030
Phone
(702) 642-8313
Fax
(702) 642-8903
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Zephyrene C Villaluz, MDNPI 1801073481
Title
President Owner
Phone
(702) 642-8313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 6679 NV Primary

Addresses

Primary practice location

1825 Civic Center Drive
N Las Vegas, NV 89030

Mailing address

1825 Civic Center Drive
N Las Vegas, NV 89030
Phone (702) 642-8313

Other identifiers 1

IdentifierTypeStateIssuer
2019236MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727001431 NV Part B Supplier - Clinic/Group Practice 0648240770 Receives reassigned benefits from 4 practitioners
Practice locations: North Las Vegas, NV

National Provider Directory

National Provider Directory

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356415616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 CIVIC CENTER DRIVE",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "89030",
            "telephone_number": "702-642-8313",
            "fax_number": "702-642-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 CIVIC CENTER DRIVE",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "89030",
            "telephone_number": "702-642-8313",
            "fax_number": "702-642-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZEPHYRENE C VILLALUZ MD CHTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VILLALUZ",
        "authorized_official_first_name": "ZEPHYRENE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "702-642-8313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "6679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019236",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in N Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.