Organization Active NPI

Jsa Professional Association

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1619906211
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JSA PROFESSIONAL ASSOCIATION
Practice address
700 E Warm Springs Rd
Suite 300
Las Vegas, NV 89119-4305
Phone
(702) 932-8547
Fax
(702) 932-8586
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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

Authorized official

Name
Dr. Bruce W Frieman, DO
Title
President, Secretary and Treasurer
Phone
(727) 824-0780

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

700 E Warm Springs Rd
Suite 300
Las Vegas, NV 89119-4305

Mailing address

700 E Warm Springs Rd
Suite 300
Las Vegas, NV 89119-4305
Phone (702) 932-8500

Other identifiers 1

IdentifierTypeStateIssuer
100509715MedicaidNV

Other names 1

  • Summit Medical Group and Healthcare Partners of Nevada Doing business as

National Provider Directory

National Provider Directory

Locations

5755 S Rainbow Blvd
Ste 101
Las Vegas, NV 89118
Phone (702) 331-1333

700 E Warm Springs Rd
Ste 300
Las Vegas, NV 89119
Phone (702) 932-8547

770 E Warm Springs Rd
#302
Las Vegas, NV 89119
Phone (702) 464-8866

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": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1619906211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E WARM SPRINGS RD",
            "address_2": "SUITE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194305",
            "telephone_number": "702-932-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E WARM SPRINGS RD",
            "address_2": "SUITE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194305",
            "telephone_number": "702-932-8547",
            "fax_number": "702-932-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSA PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "FRIEMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT, SECRETARY AND TREASURER",
        "authorized_official_telephone_number": "727-824-0780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100509715",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Medical Group and Healthcare Partners of Nevada",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 27, 2008; 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.