NPIMap

Organization Active NPI

Essential Clinic LLC

  • Primary Care Clinic/Center
  • Henderson, NV
National Provider Identifier
1629659701
Registry record updated Jun 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ESSENTIAL CLINIC LLC
Practice address
600 W Sunset Rd Ste 102
Henderson, NV 89011-4112
Phone
(000) 000-0000
NPI assigned
Apr 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2024

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

Authorized official

Name
Wally Joseph, NPNPI 1326595125
Title
Owner
Phone
(725) 241-5252

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

600 W Sunset Rd Ste 102
Henderson, NV 89011-4112

Mailing address

600 W Sunset Rd Ste 102
Henderson, NV 89011-4112
Phone (725) 241-5252

Other practice location 1

600 W Sunset Rd Ste 102
Henderson, NV 89011-4112
Phone (725) 241-5252

Other identifiers 1

IdentifierTypeStateIssuer
1326595125OtherCAFAMILY NURSE PRACTITIONER AND PSYCHIATRIC NURSE PRACTITIONER

Other names 1

  • Essential Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211006001484 NV Part B Supplier - Clinic/Group Practice 5395143341 Receives reassigned benefits from 9 practitioners
Practice locations: Henderson, NV

National Provider Directory

National Provider Directory

Locations

600 W Sunset Rd
Ste 102
Henderson, NV 89011
Phone (725) 241-5252

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 12

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": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717804800000",
    "number": "1629659701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W SUNSET RD STE 102",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114112",
            "telephone_number": "725-241-5252",
            "fax_number": "725-241-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W SUNSET RD STE 102",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114112",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W Sunset Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890114112",
            "country_code": "US",
            "telephone_number": "725-241-5252",
            "fax_number": "725-241-7474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ESSENTIAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-06-08",
        "certification_date": "2024-06-08",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "WALLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "725-241-5252",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER AND PSYCHIATRIC NURSE PRACTITIONER",
            "identifier": "1326595125",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essential Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.