NPIMap

Organization Active NPI

Las Vegas Clinic for Children & Youth

  • Pediatrics Physician
  • Las Vegas, NM
National Provider Identifier
1558429720
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LAS VEGAS CLINIC FOR CHILDREN & YOUTH
Practice address
501 7TH Street
Las Vegas, NM 87701
Phone
(505) 425-3566
Fax
(505) 425-3568
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. George P Bunch, MDNPI 1780747089
Title
President MD
Phone
(505) 425-3566

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

501 7TH Street
Las Vegas, NM 87701

Mailing address

501 7TH Street
Las Vegas, NM 87701
Phone (505) 425-3566

Other identifiers 1

IdentifierTypeStateIssuer
49395MedicaidNM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558429720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 7TH STREET",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "87701",
            "telephone_number": "505-425-3566",
            "fax_number": "505-425-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 7TH STREET",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "87701",
            "telephone_number": "505-425-3566",
            "fax_number": "505-425-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS CLINIC FOR CHILDREN & YOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUNCH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT MD",
        "authorized_official_telephone_number": "505-425-3566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49395",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.