NPIMap

Organization Active NPI

Lifeline Health Services

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1528815883
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LIFELINE HEALTH SERVICES
Doing business as
Lifeline Health Services
Practice address
601 S Rancho Dr Ste D29
Las Vegas, NV 89106-4827
Phone
(702) 840-0551
NPI assigned
May 3, 2024
Last updated
May 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Authorized official

Name
Mrs. Ngozi UgwuNPI 1184026684
Title
Secretary
Phone
(301) 254-9554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

601 S Rancho Dr Ste D29
Las Vegas, NV 89106-4827

Mailing address

601 S Rancho Dr Ste D29
Las Vegas, NV 89106-4827

Other names 1

  • Lifeline Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250808003641 NV Part B Supplier - Clinic/Group Practice 8426556432 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

601 S Rancho Dr
Ste D29
Las Vegas, NV 89106
Phone (702) 840-0551

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1528815883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S RANCHO DR STE D29",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S RANCHO DR STE D29",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064827",
            "telephone_number": "702-840-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "UGWU",
        "authorized_official_first_name": "NGOZI",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "301-254-9554",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeline Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.