Intercity Medical and Consulting Resources LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INTERCITY MEDICAL AND CONSULTING RESOURCES LLC

Practice address

4100 W Flamingo Rd
Las Vegas, NV 89103-3924

Phone

(888) 354-2758

NPI assigned

Sep 25, 2019

Organization subpart

No

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

Authorized official

Name

Elias Lu

Title

Manager

Phone

(888) 354-2758

Specialties & licenses 2

Addresses

Other names 2

• PROMED Doing business as
• Remedicus Doing business as

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569369600000",
    "number": "1639720105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 N RAINBOW BLVD # 1508",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071103",
            "telephone_number": "888-354-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891033924",
            "telephone_number": "888-354-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCITY MEDICAL AND CONSULTING RESOURCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-09-25",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "ELIAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "888-354-2758"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROMED",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Remedicus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.