NPIMap

Organization Active NPI

Charles H. Tadlock, M.D. LTD

  • Pain Medicine (Anesthesiology) Physician
  • Las Vegas, NV
National Provider Identifier
1720292642
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
48411 Issued in NV
Legal business name
CHARLES H. TADLOCK, M.D. LTD
Doing business as
CENTER FOR PAIN MANAGEMENT
Practice address
6725 S. Eastern Ave.
Suite 6
Las Vegas, NV 89119
Phone
(702) 474-0200
Fax
(702) 946-5328
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Authorized official

Name
Dr. Charles Henry Tadlock, M.D.
Title
President
Phone
(702) 474-0200

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 48411 NV Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 8402 NV
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 26067 AZ
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X PA1256 NV

Addresses

Primary practice location

6725 S. Eastern Ave.
Suite 6
Las Vegas, NV 89119

Mailing address

6725 S. Eastern Ave.
Suite 6
Las Vegas, NV 89119
Phone (702) 474-0200

Other identifiers 1

IdentifierTypeStateIssuer
100502539MedicaidNV

Other names 1

  • CENTER FOR PAIN MANAGEMENT Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444694400000",
    "number": "1720292642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 S. EASTERN AVE.",
            "address_2": "SUITE 6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89119",
            "telephone_number": "702-474-0200",
            "fax_number": "702-474-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6725 S. EASTERN AVE.",
            "address_2": "SUITE 6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89119",
            "telephone_number": "702-474-0200",
            "fax_number": "702-946-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES H. TADLOCK, M.D. LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2015-10-13",
        "status": "A",
        "authorized_official_last_name": "TADLOCK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-474-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NV",
            "license": "48411",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NV",
            "license": "8402",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AZ",
            "license": "26067",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1256",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502539",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTER FOR PAIN MANAGEMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 13, 2015; 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.