NPIMap

Organization Active NPI

Archwell Health Professional Services of Nevada, P.C.

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1487303145
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ARCHWELL HEALTH PROFESSIONAL SERVICES OF NEVADA, P.C.
Practice address
1501 W Sunset Rd
Henderson, NV 89014-6636
Phone
(888) 987-1151
NPI assigned
Mar 21, 2022
Last updated
Apr 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Lisa Lucas
Title
Chief Administrative Officer
Phone
(615) 419-0947

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X

Addresses

Primary practice location

1501 W Sunset Rd
Henderson, NV 89014-6636

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250

Other practice location 1

921 W Owens Ave Ste 150
Las Vegas, NV 89106-5405
Phone (725) 269-3364

Other practice location 2

1276 S Nellis Blvd
Las Vegas, NV 89104-5782
Phone (725) 269-6465

Other practice location 3

4750 W Sahara Ave Ste 36
Las Vegas, NV 89102-3557
Phone (725) 433-3364

Other practice location 4

3830 E Flamingo Rd # 100
Las Vegas, NV 89121-6234
Phone (725) 269-1044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220819001584 NV Part B Supplier - Clinic/Group Practice 3779966999 Receives reassigned benefits from 45 practitioners
Practice locations: Las Vegas, NV; Henderson, NV

National Provider Directory

National Provider Directory

Locations

3830 E Flamingo Rd
#100
Las Vegas, NV 89121
Phone (725) 269-1044

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1487303145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W SUNSET RD",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890146636",
            "telephone_number": "888-987-1151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 W Owens Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891065405",
            "country_code": "US",
            "telephone_number": "725-269-3364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1276 S Nellis Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891045782",
            "country_code": "US",
            "telephone_number": "725-269-6465",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4750 W Sahara Ave Ste 36",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891023557",
            "country_code": "US",
            "telephone_number": "725-433-3364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3830 E Flamingo Rd # 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891216234",
            "country_code": "US",
            "telephone_number": "725-269-1044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARCHWELL HEALTH PROFESSIONAL SERVICES OF NEVADA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-21",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "615-419-0947"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.