Faith Medical Clinic, LLC.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAITH MEDICAL CLINIC, LLC.

Practice address

3510 E Tropicana Ave Ste K
Las Vegas, NV 89121-7341

Phone

(702) 466-0069

Fax

(702) 433-1815

NPI assigned

Oct 19, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Moncada

Title

Manager

Phone

(702) 902-3039

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 4

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

• Jhouleen Angelika Tam Tiamzon

  • Gerontology Nurse Practitioner
  • Las Vegas, NV
  • NPI 1306451471

  NV, Single Specialty

  Medicare reassignment Care Compare group NPD
• Pamela Jean Winn, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1235584772

  Family Medicine, NV

  Medicare reassignment Care Compare group NPD
• Griselda Maritza Rivas, APRN-CNP

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1992656235
  NPD
• Mayra Montijo

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1659095735

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1700485083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 E TROPICANA AVE STE K",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891217341",
            "telephone_number": "702-466-0069",
            "fax_number": "702-433-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 E TROPICANA AVE STE K",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891217341",
            "telephone_number": "702-466-0069",
            "fax_number": "702-433-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH MEDICAL CLINIC, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "MONCADA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-902-3039",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faith Home Care Services
• Faith Home Health Care LLC
• Faith Impact Center LLC
• Faith in Life Counseling Center
• Faith Ind and Family Counceling
• Faith Santos, Aprn PLLC
• Faith Shari 3
• Faith Shari Adult Care II
• Faith Shari Group Home
• Faith Vision Inc

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.