Individual provider Active NPI

Robert Don Merrill, DO

  • General Practice Physician
  • Las Vegas, NV
National Provider Identifier
1669491031
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
DO3051 Issued in NV
Practice address
517 Rose St
Las Vegas, NV 89106-4020
Phone
(702) 438-4692
Fax
(702) 485-2372
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5583587-1204 UT
Obstetrics & Gynecology Physician 207V00000X PENDING NV
General Practice Physician 208D00000X DO3051 NV Primary

Addresses

Primary practice location

517 Rose St
Las Vegas, NV 89106-4020

Mailing address

2615 W Dry Creek Dr
Riverton, UT 84065-6768
Phone (801) 995-9933

Other practice location 1

3930 W Ann Rd
North Las Vegas, NV 89031-3841
Phone (702) 438-4692

Other practice location 2

6250 N Durango Dr
Las Vegas, NV 89149-3916
Phone (702) 438-4692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5583587-1204UTMDObstetrics & Gynecology Physician
DO3051NVMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. PastSince Aug 1, 2004 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1669491031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 W DRY CREEK DR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840656768",
            "telephone_number": "801-995-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 ROSE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064020",
            "telephone_number": "702-438-4692",
            "fax_number": "702-485-2372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3930 W Ann Rd",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "890313841",
            "country_code": "US",
            "telephone_number": "702-438-4692",
            "fax_number": "702-485-2372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6250 N Durango Dr",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891493916",
            "country_code": "US",
            "telephone_number": "702-438-4692",
            "fax_number": "702-485-2372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "ROBERT",
        "middle_name": "DON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "5583587-1204",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NV",
            "license": "DO3051",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 11, 2022; 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.