Vascular Institute of Southern

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

8591 Issued in NV

Legal business name

VASCULAR INSTITUTE OF SOUTHERN

Doing business as

Kenneth J. Shah, MD

Practice address

2465 W Horizon Ridge Pkwy
Suite #100
Henderson, NV 89052-2649

Phone

(702) 616-0500

Fax

(702) 616-0505

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth J. Shah, M.D.

Title

President

Phone

(702) 616-0500

Specialties & licenses 1

Addresses

Other names 1

• Kenneth J. Shah, MD Doing business as

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1508813338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2465 W HORIZON RIDGE PKWY",
            "address_2": "SUITE #100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522649",
            "telephone_number": "702-616-0500",
            "fax_number": "702-616-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 W HORIZON RIDGE PKWY",
            "address_2": "SUITE #100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522649",
            "telephone_number": "702-616-0500",
            "fax_number": "702-616-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR INSTITUTE OF SOUTHERN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-616-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NV",
            "license": "8591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenneth J. Shah, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Varsobia Home Care Services LLC
• Heather Leann Vartanian
• Vascular and Interventional Partners Las Vegas Goettl PLLC
• Vascular Assessment Specialties, Inc.
• Vascular Institute of Henderson, PC
• Satvik Vasireddy
• Cindie Vasquez
• Edwin G Vasquez
• Irma Vasquez
• Stacy M Vasquez, LCSW

• Cardiovascular Disease Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Cardiovascular Disease Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.