Organization Active NPI

Pain Institute of Nevada, Inc.

  • Pain Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1376571331
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
PAIN INSTITUTE OF NEVADA, INC.
Practice address
7065 W Ann Rd Ste 130-548
Las Vegas, NV 89130
Phone
(702) 878-8252
Fax
(702) 878-9096
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Authorized official

Name
Walter M Kidwell, MD
Title
Owner Pres Ceo
Phone
(702) 878-8252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

7065 W Ann Rd Ste 130-548
Las Vegas, NV 89130

Mailing address

7435 W Azure Dr Ste 190
Las Vegas, NV 89130-4427
Phone (702) 878-8252

Other practice location 1

600 S Rancho Dr
Ste 113
Las Vegas, NV 89106-4867
Phone (702) 878-8252 ext. 231

Other practice location 2

7065 W Ann Rd Ste 130-548
Las Vegas, NV 89130
Phone (702) 878-8252 ext. 240

National Provider Directory

National Provider Directory

Locations

4045 S Buffalo Dr
Ste A101
Las Vegas, NV 89147

7065 W Ann Rd
Ste 130548
Las Vegas, NV 89130
Phone 7028788252 ext. 240

7435 W Azure Dr
Ste 190
Las Vegas, NV 89130
Phone (702) 363-3666

4045 S Buffalo Dr
Ste A101172
Las Vegas, NV 89147
Phone (702) 878-8252

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1376571331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 W AZURE DR STE 190",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891304427",
            "telephone_number": "702-878-8252",
            "fax_number": "702-878-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7065 W ANN RD STE 130-548",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89130",
            "telephone_number": "702-878-8252",
            "fax_number": "702-878-9096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Rancho Dr",
            "address_2": "Ste 113",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064867",
            "country_code": "US",
            "telephone_number": "702-878-8252 x231",
            "fax_number": "702-878-9096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7065 W Ann Rd Ste 130-548",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89130",
            "country_code": "US",
            "telephone_number": "702-878-8252 x240",
            "fax_number": "702-878-9096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN INSTITUTE OF NEVADA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "KIDWELL",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER PRES CEO",
        "authorized_official_telephone_number": "702-878-8252",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "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 Jun 12, 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.