NPIMap

Organization Active NPI

Extensive Pain Primary and Urgent Care Center of Nevada.LLC

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1366092462
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
EXTENSIVE PAIN PRIMARY AND URGENT CARE CENTER OF NEVADA.LLC
Practice address
6465 W Sahara Ave Ste 103
Las Vegas, NV 89146-3071
Phone
(702) 822-1881
Fax
(702) 822-1880
NPI assigned
Sep 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Authorized official

Name
Dr. Twyla Rashelle Russell, BSN,MSN,APRN, FNP-BC
Title
Ownerceo
Phone
(702) 822-1881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

6465 W Sahara Ave Ste 103
Las Vegas, NV 89146-3071

Mailing address

6465 W Sahara Ave Ste 103
Las Vegas, NV 89146-3071
Phone (702) 822-1881

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1366092462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 W SAHARA AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463071",
            "telephone_number": "702-822-1881",
            "fax_number": "702-787-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 W SAHARA AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463071",
            "telephone_number": "702-822-1881",
            "fax_number": "702-822-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENSIVE PAIN PRIMARY AND URGENT CARE CENTER OF NEVADA.LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "TWYLA",
        "authorized_official_middle_name": "RASHELLE",
        "authorized_official_title_or_position": "OWNERCEO",
        "authorized_official_telephone_number": "702-822-1881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BSN,MSN,APRN, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 21, 2019; 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.