Acnm LLC
Organization Active NPI Family Medicine Physician · Las Vegas, NV
NPI 1609656131 · NPPES record last updated Oct 28, 2024
Key facts
- NPI
- 1609656131
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ACNM LLC
- Practice address
- 4560 S Eastern Ave Ste 14
Las Vegas, NV 89119-6182 - Phone
- (702) 978-1648
- NPI assigned
- Oct 2, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Mary Charmaine Estrella Campana, MD
- Title
- Manager
- Phone
- (702) 751-3336
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231024001118 | NV | Part B Supplier - Clinic/Group Practice | 3072969336 |
Receives reassigned benefits from 1 practitioner Practice locations: Las Vegas, NV |
National Provider Directory
Locations
1050 E Flamingo Rd
#7
Las Vegas, NV 89119
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
4560 S Eastern Ave Ste 14
Las Vegas, NV 89119-6182
Mailing address
1050 E Flamingo Rd
Ste 107 PMB 1926
Las Vegas, NV 89119-7429
Phone (702) 751-3336
Other names
- A Clinic Near Me
Other providers in Las Vegas, NV
- Christine Leann Ackmann
- Sandra Ackumey
- Kevin Gorkian Aclan
- Acme Assisted Living LLC
- Acnm 1 LLC
- Mona Macapugay Acoba
- Darion Acohido
- Austin William Acor
- Angel Acosta Blanco
- Yarilexy Acosta Labaut
All providers in Las Vegas, NV · Family Medicine Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.