Individual provider Active NPI

Erik Gregory Pearson, MD

  • Pediatric Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1437395407
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
17116 Issued in NV
Practice address
653 N Town Center Dr Ste 412
Las Vegas, NV 89144-0518
Phone
(702) 233-8101
NPI assigned
Dec 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0120X 17116 NV Primary

Addresses

Primary practice location

653 N Town Center Dr Ste 412
Las Vegas, NV 89144-0518

Mailing address

653 N Town Center Dr Ste 412
Las Vegas, NV 89144-0518
Phone (702) 233-8101

Other practice location 1

545 S 700 E Apt 205
Salt Lake City, UT 84102-2829
Phone (801) 707-5259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140424002232 UT Order and Referring Only - General SurgeryPractitioner - General Surgery 4880827989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17116NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Surgery Associates Single Specialty Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437395407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR STE 412",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440518",
            "telephone_number": "702-233-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR STE 412",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440518",
            "telephone_number": "702-233-8101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 S 700 E Apt 205",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841022829",
            "country_code": "US",
            "telephone_number": "801-707-5259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "ERIK",
        "middle_name": "GREGORY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NV",
            "license": "17116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.