NPIMap

Organization Active NPI

Integrative Family Medicine

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1598820185
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9444 Issued in NV
Legal business name
INTEGRATIVE FAMILY MEDICINE
Practice address
4955 S Durango Dr
#106
Las Vegas, NV 89113-1053
Phone
(702) 562-8800
Fax
(702) 562-0009
NPI assigned
Dec 26, 2006
Organization subpart
Yes
Parent organization
INTEGRATIVE FAMILY MEDICINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

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

Authorized official

Name
Corey A Wachs, DCNPI 1578785150
Title
Co-Owner/Chiropractor
Phone
(702) 562-8800

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X B00709 NV
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 9444 NV Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 585 NV

Addresses

Primary practice location

4955 S Durango Dr
#106
Las Vegas, NV 89113-1053

Mailing address

4955 S Durango Dr
#106
Las Vegas, NV 89113-1053
Phone (702) 562-8800

Other identifiers 1

IdentifierTypeStateIssuer
002088311MedicaidNV

National Provider Directory

National Provider Directory
Part of
Integrative Family Medicine

Locations

6045 S Rainbow Blvd
Ste 100
Las Vegas, NV 89118
Phone (702) 220-6457

Practitioners & affiliated clinicians

Practitioners 7

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": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1598820185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 S DURANGO DR",
            "address_2": "#106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131053",
            "telephone_number": "702-562-8800",
            "fax_number": "702-562-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 S DURANGO DR",
            "address_2": "#106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131053",
            "telephone_number": "702-562-8800",
            "fax_number": "702-562-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE FAMILY MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATIVE FAMILY MEDICINE",
        "enumeration_date": "2006-12-26",
        "last_updated": "2010-04-12",
        "status": "A",
        "authorized_official_last_name": "WACHS",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO-OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "702-562-8800",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B00709",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "9444",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "585",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002088311",
            "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 Apr 12, 2010; 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.