Woodward Ave., LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

WOODWARD AVE., LLC

Doing business as

dba Innovative Procedural and Surgical Center

Practice address

9920 W Cheyenne Ave
Suite 120
Las Vegas, NV 89129-7725

Phone

(702) 316-2281

NPI assigned

Apr 14, 2011

Last updated

Apr 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Matt Paxton

Title

Manager

Phone

(702) 316-2281

Specialties & licenses 1

Addresses

Other names 1

• dba Innovative Procedural and Surgical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Listed as

Woodward Ave LLC Dba Innovative Procedural and Surgical CenterCCN 29C0001103

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Elvin Monsalud, FNP STUDENT

  • Student in an Organized Health Care Education/Training Program
  • Bethesda, MD
  • NPI 1760239321
  NPD
• Daniel Lewis Burkhead, MD LTD

  • Interventional Pain Medicine Physician
  • Las Vegas, NV
  • NPI 1144298928
  NPD (past)
• Ryan M West, D.O.

  • Pain Medicine Physician
  • Las Vegas, NV
  • NPI 1467892919
  NPD (past)
• Willis Y Wu, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Las Vegas, NV
  • NPI 1669633046
  NPD (past)
• Ho Dzung, MD

  • Pain Medicine (Anesthesiology) Physician
  • Tacoma, WA
  • NPI 1891954293
  NPD (past)

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1568752202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9920 W CHEYENNE AVE",
            "address_2": "SUITE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 W CHEYENNE AVE",
            "address_2": "SUITE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297725",
            "telephone_number": "702-316-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODWARD AVE., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "PAXTON",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-316-2281",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Innovative Procedural and Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ambica Woodson
• Anthony Alexander Woodson
• Jessila Woodson, APRN
• Linda Stephens Woodson, M.D.
• Nateesha Woodson
• Daniel Jazz Woodward
• Johnathen Woodward, PHARMD
• Shenika Woodward
• Richard Woodworth, M.D.
• Cayce A Woody

• Ambulatory Surgical Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.