Incera LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11608 Issued in NV

Legal business name

INCERA LLC

Practice address

10885 S Eastern Ave
#100
Henderson, NV 89052-5857

Phone

(702) 419-9977

Fax

(702) 921-0222

NPI assigned

Dec 9, 2016

Organization subpart

No

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

Authorized official

Name

Horace Guerra IV, MD

Title

Owner

Phone

(702) 809-1171

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1447794466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 S JONES BLVD",
            "address_2": "#32169",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891738801",
            "telephone_number": "702-624-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10885 S EASTERN AVE",
            "address_2": "#100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525857",
            "telephone_number": "702-419-9977",
            "fax_number": "702-921-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCERA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-09",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "GUERRA",
        "authorized_official_first_name": "HORACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-809-1171",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "11608",
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "NV",
            "license": "11608",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "11608",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "6826335-1205",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "APRN001889",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Henderson, NV
• Providers in Henderson, 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 Nov 17, 2017; 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.