NPIMap

Organization Active NPI

Nova Healthcare Group LLC

  • Adult Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1548754690
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
002927 Issued in NV
Legal business name
NOVA HEALTHCARE GROUP LLC
Practice address
175 Crooked Putter Dr
Las Vegas, NV 89148-5228
Phone
(702) 268-8900
Fax
(702) 664-6729
NPI assigned
Jun 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Authorized official

Name
Ms. Anneleisa Gail McDonald, APRN-BC
Title
Provider/ Owner
Phone
(702) 268-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X 002927 NV Primary

Addresses

Primary practice location

175 Crooked Putter Dr
Las Vegas, NV 89148-5228

Mailing address

175 Crooked Putter Dr
Las Vegas, NV 89148-5228
Phone (702) 268-8900

Other identifiers 1

IdentifierTypeStateIssuer
1760723092MedicaidNV

Other names 1

  • Nova Healthcare Group Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Reachus@novahealthcaregroup.com Direct

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: reachus@novahealthcaregroup.com

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1548754690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CROOKED PUTTER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485228",
            "telephone_number": "702-268-8900",
            "fax_number": "702-664-6729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CROOKED PUTTER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485228",
            "telephone_number": "702-268-8900",
            "fax_number": "702-664-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA HEALTHCARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-20",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "ANNELEISA",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "PROVIDER/ OWNER",
        "authorized_official_telephone_number": "702-268-8900",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN-BC"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NV",
            "license": "002927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760723092",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Reachus@novahealthcaregroup.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "175 Crooked Putter Dr",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891485228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Nova Healthcare Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 28, 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.