NPIMap

Organization Active NPI

Destiny Wellness Center LLC

  • Community/Behavioral Health Agency
  • Henderson, NV
National Provider Identifier
1609515667
Registry record updated May 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DESTINY WELLNESS CENTER LLC
Practice address
4041 E Sunset Rd Ste 2
Henderson, NV 89014-0215
Phone
(702) 936-2326
NPI assigned
May 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2022

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

Authorized official

Name
Racheal Bethenii MartinNPI 1336888395
Title
Owner
Phone
(702) 886-3698

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
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4041 E Sunset Rd Ste 2
Henderson, NV 89014-0215

Mailing address

PO Box 753512
Las Vegas, NV 89136-3512

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address contact@destinywellnesscenterlv.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

4041 E Sunset Rd
Ste 2
Henderson, NV 89014
Phone (702) 809-5293

Practitioners & affiliated clinicians

Practitioners 3

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": "1653696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653696000000",
    "number": "1609515667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 753512",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891363512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 E SUNSET RD STE 2",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890140215",
            "telephone_number": "702-936-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-28",
        "last_updated": "2022-05-28",
        "certification_date": "2022-05-28",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "RACHEAL",
        "authorized_official_middle_name": "BETHENII",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-886-3698"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@destinywellnesscenterlv.com",
            "affiliation": "N",
            "endpointDescription": "secured vpn email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4041 E Sunset Rd Ste 2",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890140215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

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