NPIMap

Organization Active NPI

Dr. Rushika Fernandopulle (Iora Nevada), P.C.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1386195246
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DR. RUSHIKA FERNANDOPULLE (IORA NEVADA), P.C.
Practice address
701 E Bridger Ave
Suite 150
Las Vegas, NV 89101-5554
Phone
(702) 479-1515
Fax
(702) 410-6678
NPI assigned
Oct 17, 2016
Last updated
Dec 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Authorized official

Name
Dr. Marc-David Munk, M.D.
Title
Chief Medical Officer
Phone
(617) 454-4672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

701 E Bridger Ave
Suite 150
Las Vegas, NV 89101-5554

Mailing address

101 Tremont St FL 6
Boston, MA 02108-5004
Phone (617) 454-4671

National Provider Directory

National Provider Directory
Tax ID family
Culinary Extra Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

701 E Bridger Ave
Ste 150
Las Vegas, NV 89101
Phone (702) 308-5870

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1386195246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 TREMONT ST FL 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021085004",
            "telephone_number": "617-454-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E BRIDGER AVE",
            "address_2": "SUITE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891015554",
            "telephone_number": "702-479-1515",
            "fax_number": "702-410-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RUSHIKA FERNANDOPULLE (IORA NEVADA), P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "MUNK",
        "authorized_official_first_name": "MARC-DAVID",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "617-454-4672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "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 Dec 14, 2016; 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.