NPIMap

Organization Active NPI

Prime Healthcare Services North Vista LLC

  • Psychiatric Hospital Unit
  • North Las Vegas, NV
National Provider Identifier
1497153530
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
649HOS-34 Issued in NV
Legal business name
PRIME HEALTHCARE SERVICES NORTH VISTA LLC
Practice address
1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120
Phone
(702) 649-7711
NPI assigned
Dec 5, 2014
Organization subpart
Yes
Parent organization
PRIME HEALTHCARE SERVICES NORTH VISTA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Authorized official

Name
Prem Reddy
Title
Chairman/President
Phone
(909) 235-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 649HOS-34 NV Primary

Addresses

Primary practice location

1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120

Mailing address

1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120
Phone (702) 649-7711

Other identifiers 3

IdentifierTypeStateIssuer
100502300MedicaidNV
100502301MedicaidNV
100502299MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services North Vista LLC2 organizations share this tax ID, including this one
Part of
Prime Healthcare Services North Vista LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1497153530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307120",
            "telephone_number": "702-649-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307120",
            "telephone_number": "702-649-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES NORTH VISTA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME HEALTHCARE SERVICES NORTH VISTA LLC",
        "enumeration_date": "2014-12-05",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "PREM",
        "authorized_official_title_or_position": "CHAIRMAN/PRESIDENT",
        "authorized_official_telephone_number": "909-235-4400"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NV",
            "license": "649HOS-34",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502300",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502301",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502299",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.