NPIMap

Organization Active NPI

Great West Medical Associates Carrol LLP

Doing business as Great West Medical Associates

  • Gastroenterology Physician
  • Las Vegas, NV
National Provider Identifier
1750556940
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GREAT WEST MEDICAL ASSOCIATES CARROL LLP
Doing business as
Great West Medical Associates
Practice address
3150 N Tenaya Way
Suite 525
Las Vegas, NV 89128-0443
Phone
(702) 220-9865
Fax
(702) 251-8196
NPI assigned
Apr 28, 2008
Last updated
Jun 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Authorized official

Name
Clifford Carrol, MDNPI 1023119138
Title
Partner
Phone
(702) 220-9865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NV Primary

Addresses

Primary practice location

3150 N Tenaya Way
Suite 525
Las Vegas, NV 89128-0443

Mailing address

PO Box 34795
Las Vegas, NV 89133-4795
Phone (702) 220-9865

Other identifiers 1

IdentifierTypeStateIssuer
1750556940MedicaidNV

Other names 1

  • Great West Medical Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1750556940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34795",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891334795",
            "telephone_number": "702-220-9865",
            "fax_number": "702-251-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N TENAYA WAY",
            "address_2": "SUITE 525",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280443",
            "telephone_number": "702-220-9865",
            "fax_number": "702-251-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT WEST MEDICAL ASSOCIATES CARROL LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "CARROL",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "702-220-9865",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750556940",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great West Medical Associates",
            "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 Jun 22, 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.