NPIMap

Organization Active NPI

Ageless Men's Health

  • Specialist
  • Henderson, NV
National Provider Identifier
1386078301
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
AGELESS MEN'S HEALTH
Practice address
2560 Wigwam Pkwy
A10
Henderson, NV 89074-6226
Phone
(702) 243-0028
Fax
(702) 252-4315
NPI assigned
Aug 27, 2013
Last updated
Aug 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Authorized official

Name
Mrs. Melissa C McClellan
Title
VP of Operations
Phone
(901) 757-3643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

2560 Wigwam Pkwy
A10
Henderson, NV 89074-6226

Mailing address

2560 Wigwam Pkwy
A10
Henderson, NV 89074-6226
Phone (702) 243-0028

National Provider Directory

National Provider Directory
Tax ID family
Ageless Men's Health4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377561600000",
    "number": "1386078301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 WIGWAM PKWY",
            "address_2": "A10",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746226",
            "telephone_number": "702-243-0028",
            "fax_number": "702-252-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 WIGWAM PKWY",
            "address_2": "A10",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746226",
            "telephone_number": "702-243-0028",
            "fax_number": "702-252-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS MEN'S HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "901-757-3643",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.