NPIMap

Organization Active NPI

DMC Medical Clinic LTD

  • Primary Care Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1699374256
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
DMC MEDICAL CLINIC LTD
Practice address
1706 W Bonanza Rd
Las Vegas, NV 89106-4704
Phone
(702) 631-6863
Fax
(702) 631-6864
NPI assigned
Oct 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Authorized official

Name
Mario Godoy, CNP
Title
Medical Director
Phone
(702) 631-6863

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

1706 W Bonanza Rd
Las Vegas, NV 89106-4704

Mailing address

1706 W Bonanza Rd
Las Vegas, NV 89106-4704
Phone (702) 631-6863

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1699374256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 W BONANZA RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064704",
            "telephone_number": "702-631-6863",
            "fax_number": "702-631-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 W BONANZA RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064704",
            "telephone_number": "702-631-6863",
            "fax_number": "702-631-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMC MEDICAL CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "GODOY",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-631-6863",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "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 9, 2026; 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.