Organization Active NPI

Bright Horizon Medical Center LLC

  • Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1609684380
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BRIGHT HORIZON MEDICAL CENTER LLC
Practice address
4521 E Bonanza Rd Apt 258
Las Vegas, NV 89110-3395
Phone
(702) 661-6416
NPI assigned
Dec 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Authorized official

Name
Odelaisy Arevalo Blanco
Title
Owner
Phone
(702) 661-6416

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

4521 E Bonanza Rd Apt 258
Las Vegas, NV 89110-3395

Mailing address

4521 E Bonanza Rd Apt 258
Las Vegas, NV 89110-3395
Phone (702) 661-6416

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1609684380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 E BONANZA RD APT 258",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891103395",
            "telephone_number": "702-661-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 E BONANZA RD APT 258",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891103395",
            "telephone_number": "702-661-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT HORIZON MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "AREVALO BLANCO",
        "authorized_official_first_name": "ODELAISY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-661-6416"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Dec 26, 2024; 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.