NPIMap

Organization Active NPI

M D Developmental Agency LLC

  • Developmental - Behavioral Pediatrics Physician
  • Henderson, NV
National Provider Identifier
1417748781
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
Legal business name
M D DEVELOPMENTAL AGENCY LLC
Doing business as
M D Developmental Agency LLC
Practice address
2520 Saint Rose Pkwy # H2-216
Henderson, NV 89074-7783
Phone
(702) 268-8513
Fax
(702) 852-0430
NPI assigned
May 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Authorized official

Name
Debra Stewart
Title
Co Owner
Phone
(773) 407-7558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0006X Primary

Addresses

Primary practice location

2520 Saint Rose Pkwy # H2-216
Henderson, NV 89074-7783

Mailing address

2520 Saint Rose Pkwy Ste H2-216
Henderson, NV 89074-7783
Phone (702) 268-8513

Other names 1

  • M D Developmental Agency LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
M D Developmental Agency LLC3 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.

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1417748781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 SAINT ROSE PKWY STE H2-216",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747783",
            "telephone_number": "702-268-8513",
            "fax_number": "702-852-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 SAINT ROSE PKWY # H2-216",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747783",
            "telephone_number": "702-268-8513",
            "fax_number": "702-852-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M D DEVELOPMENTAL AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "773-407-7558"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M D Developmental Agency LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 15, 2025; 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.