NPIMap

Organization Active NPI

Marcos Gomez PA LLC

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1427414481
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1695 Issued in NV
Legal business name
MARCOS GOMEZ PA LLC
Practice address
121 Pettswood Dr
Henderson, NV 89002-3390
Phone
(702) 357-8811
NPI assigned
Jan 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Authorized official

Name
Marcos Gomez, PANPI 1447616404
Title
President
Phone
(702) 357-8811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA1695 NV Primary

Addresses

Primary practice location

121 Pettswood Dr
Henderson, NV 89002-3390

Mailing address

121 Pettswood Dr
Henderson, NV 89002-3390

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1427414481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PETTSWOOD DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890023390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PETTSWOOD DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890023390",
            "telephone_number": "702-357-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCOS GOMEZ PA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-357-8811",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1695",
            "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 Jan 6, 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.