NPIMap

Organization Active NPI

Genesis Medical Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
National Provider Identifier
1669136628
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GENESIS MEDICAL CENTER LLC
Practice address
3216 W Charleston Blvd Ste C
Las Vegas, NV 89102-1983
Phone
(170) 249-8890
NPI assigned
Oct 26, 2021
Last updated
Oct 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Authorized official

Name
Dayana Santander MoralesNPI 1962943159
Title
Manager
Phone
(702) 498-8903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3216 W Charleston Blvd Ste C
Las Vegas, NV 89102-1983

Mailing address

3216 W Charleston Blvd Ste C
Las Vegas, NV 89102-1983
Phone (170) 249-8890

Other identifiers 1

IdentifierTypeStateIssuer
1MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@dcmedical.info

National Provider Directory

National Provider Directory

Locations

3216 W Charleston Blvd
Ste C
Las Vegas, NV 89102
Phone (702) 333-1054

Practitioners & affiliated clinicians

Practitioners 1

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": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1669136628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 W CHARLESTON BLVD STE C",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021983",
            "telephone_number": "170-249-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 W CHARLESTON BLVD STE C",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021983",
            "telephone_number": "170-249-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "SANTANDER MORALES",
        "authorized_official_first_name": "DAYANA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-498-8903"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@dcmedical.info",
            "affiliation": "N",
            "address_1": "3216 W Charleston Blvd Ste C",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891021983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 26, 2021; 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.