Individual provider Active NPI

John Caraway, DO

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1710546304
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO3075 Issued in NV
Practice address
888 S Rancho Dr
Las Vegas, NV 89106-3810
Phone
(702) 877-5199
NPI assigned
Jun 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SL1415 NV
Family Medicine Physician 207Q00000X DO3075 NV Primary

Addresses

Primary practice location

888 S Rancho Dr
Las Vegas, NV 89106-3810

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

5400 S Rainbow Blvd
Las Vegas, NV 89118-1859
Phone (702) 853-3000

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
I20220815001681 NV Practitioner - Family Practice 9234464819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

888 S Rancho Dr
Las Vegas, NV 89106-3810
Phone (702) 579-3253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO3075NVMDFamily Medicine Physician
SL1415NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C CurrentSince Aug 1, 2022 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Aug 1, 2022 Accepting new patients

Locations

888 S Rancho Dr
Las Vegas, NV 89106
Phone (702) 877-5375

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

Interoperability endpoints

  • Direct secure messaging: jcaraway119299@westdirect.optum.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1710546304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S RANCHO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063810",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 S Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891181859",
            "country_code": "US",
            "telephone_number": "702-853-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARAWAY",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-07",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "SL1415",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO3075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.