Matthew K Mortensen DC LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MATTHEW K MORTENSEN DC LTD

Practice address

8576 W Lake Mead Blvd
Las Vegas, NV 89128-7630

Phone

(702) 255-3003

Fax

(702) 255-8133

NPI assigned

Jan 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Mortensen, D.C.NPI 1558419705

Title

President

Phone

(702) 255-3003

Specialties & licenses 1

Addresses

Other names 1

• Lake Mead Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew K. Mortensen, D.C.

  • Chiropractor
  • Las Vegas, NV
  • NPI 1558419705
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200096000000",
    "number": "1487830154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8576 W LAKE MEAD BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287630",
            "telephone_number": "702-255-3003",
            "fax_number": "702-255-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8576 W LAKE MEAD BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287630",
            "telephone_number": "702-255-3003",
            "fax_number": "702-255-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW K MORTENSEN DC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-12",
        "last_updated": "2008-01-12",
        "status": "A",
        "authorized_official_last_name": "MORTENSEN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-255-3003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Mead Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Chiropractor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2008; 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.