NPIMap

Organization Active NPI

Nevada State Family Clinic, LLC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1437415304
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN000962 Issued in NV
Legal business name
NEVADA STATE FAMILY CLINIC, LLC
Practice address
3815 S. Jones Blvd Ste. 1
Las Vegas, NV 89103
Phone
(702) 431-3122
Fax
(702) 558-2090
NPI assigned
Apr 5, 2012
Last updated
Apr 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Authorized official

Name
Alan Jauregui, NURSE PRACTIONER
Title
Managing Member
Phone
(702) 266-7277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X APN000962 NV Primary

Addresses

Primary practice location

3815 S. Jones Blvd Ste. 1
Las Vegas, NV 89103

Mailing address

3815 S. Jones Blvd Ste. 1
Las Vegas, NV 89103
Phone (702) 431-3122

National Provider Directory

National Provider Directory

Locations

3815 S Jones Blvd
#1
Las Vegas, NV 89103
Phone (702) 431-3122

3815 S Jones Blvd
Ste 1
Las Vegas, NV 89103
Phone (702) 431-3122

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1437415304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 S. JONES BLVD STE. 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89103",
            "telephone_number": "702-431-3122",
            "fax_number": "702-558-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 S. JONES BLVD STE. 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89103",
            "telephone_number": "702-431-3122",
            "fax_number": "702-558-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA STATE FAMILY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "JAUREGUI",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-266-7277",
        "authorized_official_credential": "NURSE PRACTIONER"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APN000962",
            "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 Apr 5, 2012; 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.