NPIMap

Organization Active NPI

Internal Medicine Associates Laboratory

  • Clinical Medical Laboratory
  • Las Vegas, NV
National Provider Identifier
1659538411
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
29D0538607 Issued in NV
Legal business name
INTERNAL MEDICINE ASSOCIATES LABORATORY
Practice address
3121 S Maryland Pkwy
Suite 301
Las Vegas, NV 89109-2307
Phone
(702) 369-1344
Fax
(702) 369-6550
NPI assigned
May 20, 2008
Organization subpart
Yes
Parent organization
INTERNAL MEDICINE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Mrs. Kimberly A Berman
Title
Administration
Phone
(702) 464-7127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 29D0538607 NV Primary

Addresses

Primary practice location

3121 S Maryland Pkwy
Suite 301
Las Vegas, NV 89109-2307

Mailing address

6301 Mountain Vista St
Suite 203
Henderson, NV 89014-2364
Phone (702) 792-4336

Other identifiers 1

IdentifierTypeStateIssuer
100506353MedicaidNV

National Provider Directory

National Provider Directory
Part of
Copeland - Beajow Medical Institute CHTD

Locations

3121 S Maryland Pkwy
Ste 301
Las Vegas, NV 89109
Phone (702) 369-1344

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1659538411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 MOUNTAIN VISTA ST",
            "address_2": "SUITE 203",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142364",
            "telephone_number": "702-792-4336",
            "fax_number": "702-385-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 S MARYLAND PKWY",
            "address_2": "SUITE 301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092307",
            "telephone_number": "702-369-1344",
            "fax_number": "702-369-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES LABORATORY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERNAL MEDICINE ASSOCIATES",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "BERMAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "702-464-7127",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NV",
            "license": "29D0538607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506353",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.