NPIMap

Organization Active NPI

David Elliott

  • Internal Medicine Physician
  • Las Vegas, NM
National Provider Identifier
1649408121
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
76-31 Issued in NM
Legal business name
DAVID ELLIOTT
Practice address
105 Mills Ave Ste 300
Las Vegas, NM 87701-4169
Phone
(505) 425-9311
Fax
(505) 425-9047
NPI assigned
Jun 23, 2009
Last updated
Jun 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Authorized official

Name
Dr. David H Elliott, M.D.
Title
Owner
Phone
(505) 425-9311

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 76-31 NM Primary
Physician Assistant 363A00000X 92-PA09 NM
Nurse Practitioner 363L00000X R53421 NM

Addresses

Primary practice location

105 Mills Ave Ste 300
Las Vegas, NM 87701-4169

Mailing address

105 Mills Ave Ste 300
Las Vegas, NM 87701-4169
Phone (505) 425-9311

Other identifiers 1

IdentifierTypeStateIssuer
13003MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
David H Elliott MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245715200000",
    "number": "1649408121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MILLS AVE STE 300",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014169",
            "telephone_number": "505-425-9311",
            "fax_number": "505-425-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MILLS AVE STE 300",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014169",
            "telephone_number": "505-425-9311",
            "fax_number": "505-425-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID ELLIOTT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-425-9311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "76-31",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "92-PA09",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "R53421",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13003",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; 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.