702 Family Practice LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

702 FAMILY PRACTICE LLC

Practice address

3468 E Sahara Ave Ste 160
Las Vegas, NV 89104-4827

Phone

(702) 389-5700

NPI assigned

Nov 16, 2024

Organization subpart

No

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

Authorized official

Name

Iredila Timagos BynumNPI 1740044627

Title

Owner

Phone

(702) 389-5700

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Iredila Timagos Bynum, APRN FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1740044627

  Family

  NPD Authorized official

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

{
    "created_epoch": "1731715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1548085491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3468 E SAHARA AVE STE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891044827",
            "telephone_number": "702-389-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3468 E SAHARA AVE STE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891044827",
            "telephone_number": "702-389-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "702 FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-16",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "BYNUM",
        "authorized_official_first_name": "IREDILA",
        "authorized_official_middle_name": "TIMAGOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-389-5700"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Las Vegas, NV
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.