Infectious Disease Providers of Nevada LTD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

INFECTIOUS DISEASE PROVIDERS OF NEVADA LTD

Practice address

2900 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5014

Phone

(702) 307-5522

Fax

(702) 991-7258

NPI assigned

Feb 3, 2022

Organization subpart

No

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

Authorized official

Name

Todd Radivan

Title

Managing Director

Phone

(702) 307-5522

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1700530250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 W HORIZON RIDGE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525014",
            "telephone_number": "702-307-5522",
            "fax_number": "702-991-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W HORIZON RIDGE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525014",
            "telephone_number": "702-307-5522",
            "fax_number": "702-991-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE PROVIDERS OF NEVADA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "RADIVAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "702-307-5522"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandro Jimenez Incera, AGNP
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• Indigo Home Health Services Inc
• Maria De la Caridad Infante Fernandez
• Infectious Diseases of Southern Nevada a Professional LLC
• Infinite Way Behavior
• Infused Therapies, LLC
• Infusion Therapy of Nevada LLC
• Infusion Therapy of the United States, Inc.

• Infectious Disease Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Infectious Disease Physician in Nevada

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