Procare Medical Group LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

12502 Issued in NV

Legal business name

PROCARE MEDICAL GROUP LLC

Practice address

6870 S Rainbow Blvd
Suite 106 & 107
Las Vegas, NV 89118-2106

Phone

(702) 396-6000

Fax

(702) 396-6001

NPI assigned

May 2, 2008

Organization subpart

No

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

Authorized official

Name

Amber Gantz

Title

Practice Administrator

Phone

(702) 396-6000

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1366618019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6870 S RAINBOW BLVD",
            "address_2": "SUITE 106 & 107",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182106",
            "telephone_number": "702-396-6000",
            "fax_number": "702-396-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6870 S RAINBOW BLVD",
            "address_2": "SUITE 106 & 107",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182106",
            "telephone_number": "702-396-6000",
            "fax_number": "702-396-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GANTZ",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "702-396-6000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "12502",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NV",
            "license": "12502",
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "12502",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alyssa Proctor
• Andre Proctor
• Danielle Proctor
• Jennifer Amanda Proctor

• Urgent Care Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Urgent Care Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.