Gavin Holmes Pope, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

909 Issued in NV

Practice address

2020 Palomino LN Ste 110
Las Vegas, NV 89106-4892

Phone

(702) 474-7200

Fax

(702) 474-0009

NPI assigned

Jan 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Bone & Joint Specialists

  • Orthopaedic Surgery Physician
  • Las Vegas, NV
  • NPI 1912184177
  Medicare reassignment NPD

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1366420549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064892",
            "telephone_number": "702-474-7200",
            "fax_number": "702-474-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064892",
            "telephone_number": "702-474-7200",
            "fax_number": "702-474-0009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2680 Crimson Canyon Dr",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280841",
            "country_code": "US",
            "telephone_number": "702-228-7355",
            "fax_number": "702-228-4499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POPE",
        "first_name": "GAVIN",
        "middle_name": "HOLMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506320",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS",
            "identifier": "CC7717",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00835002",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annie Denise Pope
• Anthony A Pope
• Ashleah Nadene Pope, CRNA
• Dante'Sia Pope
• Frederick Eagles Pope, M.D.
• Joetta Pope
• Jordan Arielle Pope
• Katrina J Pope, RBT
• La'Resha Pope
• Laurel Pope, PA C

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.