NPIMap

Organization Active NPI

Frontier Medical & Behavioral Center Inc

  • Psychiatry Physician
  • North Las Vegas, NV
National Provider Identifier
1639579162
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FRONTIER MEDICAL & BEHAVIORAL CENTER INC
Practice address
5105 Camino Al Norte
Suite 100
North Las Vegas, NV 89031-2373
Phone
(702) 750-2438
Fax
(702) 750-2173
NPI assigned
Sep 3, 2014
Last updated
Sep 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Authorized official

Name
Jerome Nwanna Nwokike, M.D.NPI 1346225794
Title
Owner
Phone
(702) 750-2438

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Forensic Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084F0202X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

5105 Camino Al Norte
Suite 100
North Las Vegas, NV 89031-2373

Mailing address

5105 Camino Al Norte
Suite 100
North Las Vegas, NV 89031-2373
Phone (702) 750-2438

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161010001585 NV Part B Supplier - Clinic/Group Practice 4183912017 Receives reassigned benefits from 9 practitioners
Practice locations: N Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

5105 Camino Al Norte
Ste 100
North Las Vegas, NV 89031
Phone (702) 750-2438

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1639579162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 CAMINO AL NORTE",
            "address_2": "SUITE 100",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890312373",
            "telephone_number": "702-750-2438",
            "fax_number": "702-750-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 CAMINO AL NORTE",
            "address_2": "SUITE 100",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890312373",
            "telephone_number": "702-750-2438",
            "fax_number": "702-750-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER MEDICAL & BEHAVIORAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "NWOKIKE",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "NWANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-750-2438",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.