Medical Genetics of Nevada LLC

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

Legal business name

MEDICAL GENETICS OF NEVADA LLC

Practice address

2538 Anthem Village Dr Ste 110
Henderson, NV 89052-5551

Phone

(702) 732-6800

Fax

(702) 932-9611

NPI assigned

Jun 18, 2020

Organization subpart

No

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

Authorized official

Name

Susanna Sorrentino, M.D.

Title

Physician

Phone

(702) 732-6800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1366068041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2538 ANTHEM VILLAGE DR STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525551",
            "telephone_number": "702-732-6800",
            "fax_number": "702-932-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2538 ANTHEM VILLAGE DR STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525551",
            "telephone_number": "702-732-6800",
            "fax_number": "702-932-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL GENETICS OF NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "SORRENTINO",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "702-732-6800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770741555",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Genetics (M.D.) Physician in Henderson, NV
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.