NPIMap

Organization Active NPI

David S. Gothelf, a Professional Corporation

  • Family Medicine Physician
  • Henderson, NV
National Provider Identifier
1508934977
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1100 Issued in NV
Legal business name
DAVID S. GOTHELF, A PROFESSIONAL CORPORATION
Practice address
100 N Green Valley Pkwy
Suite 210
Henderson, NV 89074-6391
Phone
(702) 269-9995
Fax
(702) 944-4056
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Authorized official

Name
Dr. David S Gothelf, D.O.
Title
President
Phone
(702) 269-9995

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 479 NV
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 1100 NV Primary

Addresses

Primary practice location

100 N Green Valley Pkwy
Suite 210
Henderson, NV 89074-6391

Mailing address

100 N Green Valley Pkwy
Suite 210
Henderson, NV 89074-6391
Phone (702) 269-9995

Other names 1

  • Desert Family Medicine of Green Valley Doing business as

National Provider Directory

National Provider Directory

Locations

100 N Green Valley Pkwy
Ste 210
Henderson, NV 89074
Phone (702) 269-9995

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1508934977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY",
            "address_2": "SUITE 210",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746391",
            "telephone_number": "702-269-9995",
            "fax_number": "702-944-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY",
            "address_2": "SUITE 210",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746391",
            "telephone_number": "702-269-9995",
            "fax_number": "702-944-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID S. GOTHELF, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "GOTHELF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-269-9995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "479",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "1100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Family Medicine of Green Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 19, 2012; 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.