Indigo-Bane LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

INDIGO-BANE LLC

Doing business as

lo-go-pae-dics

Practice address

330 E Warm Springs Rd Ste 122
Las Vegas, NV 89119-4281

Phone

(725) 255-5321

Fax

(725) 255-5323

NPI assigned

May 3, 2024

Last updated

May 3, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

INDIGO-BANE LLCAs reported in NPPES

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

Authorized official

Name

Michael Lopez

Title

Manager

Phone

(725) 255-5321

Specialties & licenses 1

Addresses

Other names 1

• lo-go-pae-dics Doing business as

Part of

Indigo-Bane LLC

Locations

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.

• Christopher William Borsellino, MS CCC-SLP

  • Speech-Language Pathologist
  • Las Vegas, NV
  • NPI 1487811576
  NPD

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1689421976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E WARM SPRINGS RD STE 122",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194281",
            "telephone_number": "725-255-5321",
            "fax_number": "725-255-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E WARM SPRINGS RD STE 122",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194281",
            "telephone_number": "725-255-5321",
            "fax_number": "725-255-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO-BANE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIGO-BANE LLC",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "725-255-5321"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "lo-go-pae-dics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Speech-Language Pathologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Speech-Language Pathologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.