Smitha Muthialu, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9869 Issued in NV

Practice address

4475 S Eastern
Las Vegas, NV 89119

Phone

(702) 737-1880

Fax

(702) 650-0763

NPI assigned

Feb 8, 2006

Last updated

Feb 14, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Linda L. Johnson MD, LTD

  dba SMA Convenient Care

  • Adult Medicine Physician
  • Henderson, NV
  • NPI 1376838110
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1447223839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-737-1880",
            "fax_number": "702-650-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 S EASTERN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89119",
            "telephone_number": "702-737-1880",
            "fax_number": "702-650-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHIALU",
        "first_name": "SMITHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "9869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018444",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3102444",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447223839",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yurismelis Mustell
• Deanna Musterd
• Melody Mutch, RBT
• Dalin Muth, APRN, PMHNP-BC
• Ramanathan Muthaiah, MD
• Charlotte Mutin
• Jeanne Mutongerwa
• Paige Mutton
• Marychristine Muturi, LPN
• Anita Muwanika

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.