Active NPI
Nana Kobina Kufuor, MD
- Pediatrics Physician
- Las Vegas, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- NV9118
- Practice address
- 4840 E Bonanza St
Suite 5
Las Vegas, NV 89110 - Phone
- (702) 823-2118
- Fax
- (702) 823-2339
- NPI assigned
- Feb 1, 2006
- Last updated
- Apr 10, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 9118 | NV | |
| Pediatrics Physician | 208000000X | NV9118 | NE | Primary |
Addresses
Primary practice location
4840 E Bonanza St
Suite 5
Las Vegas, NV 89110
Mailing address
PO Box 371299
Las Vegas, NV 89137
Phone (702) 869-6544
Other practice location 1
653 NTown Center Drive
600
Las Vegas, NV 89144
Phone (702) 869-6544
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002018350 | Medicaid | NV | |
| 003102350 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NV9118 | NE | MD | Pediatrics Physician |
| 9118 | NV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pioneer Pediatrics Inc | Pediatrics | Current | Accepting new patients |
| Sunrise Mountainview Hospital, Inc. | Past | Accepting new patients | |
| Centennial Hills Hospital Medical Center | Past | Accepting new patients | |
| Summerlin Hospital Medical Center L L C | Past | Accepting new patients | |
| Sunrise Hospital and Medical Center, LLC | Past | Accepting new patients |
Locations
1040 S Rainbow Blvd
Ste 101
Las Vegas, NV 89145
Phone (702) 203-1715
4840 E Bonanza Rd
Ste 5
Las Vegas, NV 89110
Phone (702) 370-7842
653 N Town Center Dr
Ste 600
Las Vegas, NV 89144
Phone (702) 363-9466
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1487771812
-
dba Summerlin Hospital Medical Center
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1831189638
-
dba Sunrise Hospital and Medical Center
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1861439952
-
dba Mountainview Hospital
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1104870187
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1750353116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 371299",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89137",
"telephone_number": "702-869-6544",
"fax_number": "702-541-7976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4840 E BONANZA ST",
"address_2": "SUITE 5",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89110",
"telephone_number": "702-823-2118",
"fax_number": "702-823-2339"
}
],
"practiceLocations": [
{
"address_1": "653 NTown Center Drive",
"address_2": "600",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "89144",
"country_code": "US",
"telephone_number": "702-869-6544",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUFUOR",
"first_name": "NANA",
"middle_name": "KOBINA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-01",
"last_updated": "2023-04-10",
"certification_date": "2023-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NV",
"license": "9118",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NE",
"license": "NV9118",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002018350",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003102350",
"state": "NV"
}
],
"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 Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.