Individual provider Active NPI

Ran Jia, M.D.

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1598830416
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13443 Issued in NV
Practice address
100 N Green Valley Pkwy
#240
Henderson, NV 89074-6391
Phone
(702) 938-0088
Fax
(702) 260-4689
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01049735A IN
Emergency Medicine Physician 207P00000X A70416 CA
Emergency Medicine Physician 207P00000X K8769 TX
Internal Medicine Physician 207R00000X 13443 NV Primary

Addresses

Primary practice location

100 N Green Valley Pkwy
#240
Henderson, NV 89074-6391

Mailing address

PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346

Other identifiers 1

IdentifierTypeStateIssuer
1598830416MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000936 NV Practitioner - Internal Medicine 7012982424 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01049735AINMDEmergency Medicine Physician
K8769TXMDEmergency Medicine Physician
13443NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Medical Group Coats LTD Internal Medicine Current Accepting new patients
American Current Care PA Current Accepting new patients
Intermountain Medical Holdings Nevada Inc Internal Medicine Past Accepting new patients
Northern Indiana Emergency Physicians, LLP Emergency Medicine Past Accepting new patients

Locations

149 N Gibson Rd
Ste H
Henderson, NV 89014
Phone (702) 558-6275

5850 Polaris Ave
Ste 100
Las Vegas, NV 89118
Phone (702) 739-9957

255 Glendale Ave
Ste 12
Sparks, NV 89431
Phone (775) 356-8181

Interoperability endpoints

  • Direct secure messaging: ran.jia.1@15442.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1598830416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY",
            "address_2": "#240",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746391",
            "telephone_number": "702-938-0088",
            "fax_number": "702-260-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIA",
        "first_name": "RAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01049735A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A70416",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K8769",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "13443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598830416",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.