Community Care Health Plan of Nevada, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

17690 Issued in NV

Legal business name

COMMUNITY CARE HEALTH PLAN OF NEVADA, INC.

Doing business as

Anthem Blue Cross and Blue Shield Healthcare Solutions

Practice address

9133 West Russell Road
Building 9
Las Vegas, NV 89148-8351

Phone

(702) 545-9842

Fax

(702) 360-0755

NPI assigned

Oct 3, 2008

Organization subpart

No

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

Authorized official

Name

Lisa J Bogard

Title

President and Ceo

Phone

(702) 545-9842

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 2

• Anthem Blue Cross and Blue Shield Healthcare Solutions Doing business as
• AMERIGROUP Nevada, Inc. Former legal business name

Locations

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1467603878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9133 WEST RUSSELL ROAD",
            "address_2": "BUILDING 9",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891488351",
            "telephone_number": "702-545-9842",
            "fax_number": "702-360-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9133 WEST RUSSELL ROAD",
            "address_2": "BUILDING 9",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891488351",
            "telephone_number": "702-545-9842",
            "fax_number": "702-360-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE HEALTH PLAN OF NEVADA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "BOGARD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "702-545-9842"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NV",
            "license": "17690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - NORTH",
            "identifier": "100515750",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - SOUTH",
            "identifier": "100515749",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17690",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anthem Blue Cross and Blue Shield Healthcare Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AMERIGROUP Nevada, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Communities in Schools of Nevad (Future Smiles)
• Community Access Network LLC
• Community Alliance Network and Development Outreach
• Community Alliance Network and Developmental Outreach (Cando)
• Community Benefits Consortium, Inc. (Alternate Home Solutions)
• Community Care Hospice
• Community Chiropractic LLC
• Community Compassion Care, LLC
• Community Connect, Inc.
• Community Counseling and Behavioral Health

• Health Maintenance Organization in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Health Maintenance Organization in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.