Individual provider Active NPI

Johnn Gregory Trautwein, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Las Vegas, NV
National Provider Identifier
1629185194
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
10939 Issued in NV
Practice address
1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone
(702) 383-1958
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 10939 NV Primary

Addresses

Primary practice location

1800 W Charleston Blvd
Las Vegas, NV 89102-2329

Mailing address

1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-2000

Other practice location 1

3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (701) 616-5000

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
I20040902001407 NV Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1951377795 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10939NVMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Nevada Bessler PLLC CurrentSince Jul 1, 2020 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Jul 1, 2024 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Jul 1, 2024 Accepting new patients
Emergency Medicine Physicians of Clark Pediatrics McCourt, PLLC Past Accepting new patients

Locations

3001 Saint Rose Pkwy
Henderson, NV 89052
Phone (702) 615-5000

3001 Saint Rose Pkwy
#P
Henderson, NV 89052
Phone (702) 616-5423

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1629185194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022329",
            "telephone_number": "702-383-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022329",
            "telephone_number": "702-383-1958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Saint Rose Pkwy",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890523839",
            "country_code": "US",
            "telephone_number": "701-616-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAUTWEIN",
        "first_name": "JOHNN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NV",
            "license": "10939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.