Organization Active NPI

Nathan Ibe Ozobia MD Chartered

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1538491964
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3239 Issued in NV
Legal business name
NATHAN IBE OZOBIA MD CHARTERED
Practice address
5701 W Charleston Blvd
Suite 105
Las Vegas, NV 89146-1217
Phone
(702) 643-0500
Fax
(702) 471-1049
NPI assigned
Feb 10, 2010
Last updated
Sep 25, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
NATHAN IBE OZOBIA MD FICS CHARTEREDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Dr. Nathan Ibezimako Ozobia, MD FACS
Title
President
Phone
(702) 643-0500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 3239 NV
Specialist 174400000X 3239 NV Primary

Addresses

Primary practice location

5701 W Charleston Blvd
Suite 105
Las Vegas, NV 89146-1217

Mailing address

PO Box 27619
Las Vegas, NV 89126-1619
Phone (702) 643-0500

Other identifiers 1

IdentifierTypeStateIssuer
CS969AOtherNVMEDICARE PTAN

National Provider Directory

National Provider Directory
Part of
Nathan I Ozobia MD CHTD

Locations

5701 W Charleston Blvd
Las Vegas, NV 89146
Phone (702) 643-0500

5701 W Charleston Blvd
Ste 100
Las Vegas, NV 89146
Phone (702) 877-9514

Practitioners & affiliated clinicians

Practitioners 2

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": "1265760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1538491964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27619",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891261619",
            "telephone_number": "702-643-0500",
            "fax_number": "702-471-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W CHARLESTON BLVD",
            "address_2": "SUITE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461217",
            "telephone_number": "702-643-0500",
            "fax_number": "702-471-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHAN IBE OZOBIA MD CHARTERED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATHAN IBE OZOBIA MD FICS CHARTERED",
        "enumeration_date": "2010-02-10",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "OZOBIA",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "IBEZIMAKO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-643-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD FACS"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NV",
            "license": "3239",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "3239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CS969A",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 25, 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.