Individual provider Active NPI

Tierney Lynne Tirey, M.D.

  • General Practice Physician
  • North Las Vegas, NV
National Provider Identifier
1710102991
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5410 Issued in NV
Practice address
1825 Civic Center Dr
North Las Vegas, NV 89030-7113
Phone
(702) 642-8313
Fax
(702) 642-8903
NPI assigned
Apr 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5410 NV Primary

Addresses

Primary practice location

1825 Civic Center Dr
North Las Vegas, NV 89030-7113

Mailing address

1825 Civic Center Dr
North Las Vegas, NV 89030-7113
Phone (702) 642-8313

Other identifiers 1

IdentifierTypeStateIssuer
2019510MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040804000758 NV Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Emergency Medicine 8426029356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zephyrene C Villaluz MD CHTDGroup PAC ID 0648240770, 2 clinicians

Practice addresses (Care Compare)

1825 Civic Ctr Dr
North Las Vegas, NV 89030-7113
Phone (702) 642-8313

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Vista Hospital LLC Past Accepting new patients
North Vista Hospital LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710102991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 CIVIC CENTER DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307113",
            "telephone_number": "702-642-8313",
            "fax_number": "702-642-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 CIVIC CENTER DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307113",
            "telephone_number": "702-642-8313",
            "fax_number": "702-642-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIREY",
        "first_name": "TIERNEY",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NV",
            "license": "5410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019510",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.