Individual provider Active NPI

Itha Dalrymple, D.O.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1356758833
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2250 Issued in NV
Practice address
2875 S Nellis Blvd Ste 3
Las Vegas, NV 89121-2087
Phone
(702) 843-2420
Fax
(833) 749-0351
NPI assigned
Jul 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DO2250 NV Primary

Addresses

Primary practice location

2875 S Nellis Blvd Ste 3
Las Vegas, NV 89121-2087

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (702) 843-2420

Other practice location 1

1535 W Warm Springs Rd Ste 135
Henderson, NV 89014-4343
Phone (702) 450-3385

Other identifiers 2

IdentifierTypeStateIssuer
1356758833MedicaidNV
DO2250OtherNVSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address itha.dalrymple@centerwell.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824003624 NV Practitioner - Family Practice 1153606579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Hospitalists LLPGroup PAC ID 7214076322, 197 clinicians

Practice addresses (Care Compare)

7495 W Azure Dr
Suite 209
Las Vegas, NV 89130-4440
Phone (702) 407-7700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Hospitalists LLP Family Medicine CurrentSince Mar 30, 2025 Accepting new patients
Platinum Hospitalists LLP Family Medicine CurrentSince Mar 30, 2025 Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
Intermountain Medical Holdings Nevada Inc Family Medicine Past Accepting new patients

Locations

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

10624 S Eastern Ave
Ste A995
Henderson, NV 89052

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1356758833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "702-843-2420",
            "fax_number": "833-749-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 S NELLIS BLVD STE 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891212087",
            "telephone_number": "702-843-2420",
            "fax_number": "833-749-0351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1535 W Warm Springs Rd Ste 135",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890144343",
            "country_code": "US",
            "telephone_number": "702-450-3385",
            "fax_number": "702-898-1699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALRYMPLE",
        "first_name": "ITHA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO2250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356758833",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DO2250",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "itha.dalrymple@centerwell.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "2875 S Nellis Blvd Ste 3",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891212087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.