Direct Healthcare of Nevada PC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

DIRECT HEALTHCARE OF NEVADA PC

Practice address

5353 S Jones Blvd
Las Vegas, NV 89118-0537

Phone

(702) 846-5978

Fax

(702) 846-0305

NPI assigned

Jun 12, 2021

Organization subpart

No

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

Authorized official

Name

Rilwan Olalekan Shoyombo, APRN

Title

President/Provider

Phone

(702) 846-5978

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1623456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627084800000",
    "number": "1689242190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 S JONES BLVD APT 1016",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891180539",
            "telephone_number": "702-846-5978",
            "fax_number": "702-846-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891180537",
            "telephone_number": "702-846-5978",
            "fax_number": "702-846-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT HEALTHCARE OF NEVADA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-12",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A",
        "authorized_official_last_name": "SHOYOMBO",
        "authorized_official_first_name": "RILWAN",
        "authorized_official_middle_name": "OLALEKAN",
        "authorized_official_title_or_position": "PRESIDENT/PROVIDER",
        "authorized_official_telephone_number": "702-846-5978",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Direct 2 U Lab LLC
• Direct Focus Counseling Group
• Direct MD Nevada II LLC
• Direct MD Nevada LLC
• Direct Mobile CT, LLC.
• Direct Mobile Imaging
• Direct Scripts Mail, LLC

• Gerontology Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Gerontology Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.