Desert Primary Care PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

DESERT PRIMARY CARE PLLC

Practice address

5233 S Eastern Ave
Las Vegas, NV 89119-2311

Phone

(702) 878-9500

NPI assigned

Nov 21, 2022

Last updated

May 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Reena JohnNPI 1801042528

Title

Managing Director

Phone

(702) 878-9500

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reena John, APN

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1801042528
  Medicare reassignment NPD Authorized official
• Allison Lynn Martinez, FNP-BC

  • Nurse Practitioner
  • Las Vegas, NV
  • NPI 1295620771
  NPD (past)
• Mira Ajay Vakil, M.D

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1225179286
  NPD (past)

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1396454070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5233 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891192311",
            "telephone_number": "702-878-9500",
            "fax_number": "702-878-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5233 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891192311",
            "telephone_number": "702-878-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-21",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "REENA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "702-878-9500"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Orthopaedic Center, LTD.
• Desert Pain & Wellness Clinic LLC
• Desert Parkway Behavioral Healthcare Hospital, LLC
• Desert Peace Therapy LLC
• Desert Pines Family Health Center
• Desert Pulmonary Rehabilitation and Diagnostics LLC
• Desert Pulmonary Rehabilitation and Diagnostics LLC
• Desert Retina PLLC
• Desert Ridge Acupuncture LLC
• Desert Rose Homecare LLC

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.