Organization Active NPI

Kappellini Medical Inc.

  • Nephrology Physician
  • Las Vegas, NV
National Provider Identifier
1730246539
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
C14-00412-3-116128 Issued in NV
Legal business name
KAPPELLINI MEDICAL INC.
Practice address
900 S Main St
Las Vegas, NV 89101-6425
Phone
(702) 369-3699
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Authorized official

Name
Dr. Cyril Akokotu Ovuworie, M.D.NPI 1255498135
Title
Medical Director
Phone
(702) 369-3699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X C14-00412-3-116128 NV Primary

Addresses

Primary practice location

900 S Main St
Las Vegas, NV 89101-6425

Mailing address

900 S Main St
Las Vegas, NV 89101-6425
Phone (702) 369-3699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040629001018 NV Part B Supplier - Clinic/Group Practice 6103802194 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV; North Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

1815 E Lake Mead Blvd
North Las Vegas, NV 89030
Phone (702) 360-6404

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1730246539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S MAIN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016425",
            "telephone_number": "702-369-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S MAIN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016425",
            "telephone_number": "702-369-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAPPELLINI MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "OVUWORIE",
        "authorized_official_first_name": "CYRIL",
        "authorized_official_middle_name": "AKOKOTU",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-369-3699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "C14-00412-3-116128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 24, 2021; 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.