Genesis Wound Care of Las Vegas, LLC

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

Legal business name

GENESIS WOUND CARE OF LAS VEGAS, LLC

Practice address

2410 Fire Mesa St
Suite 160
Las Vegas, NV 89128-9016

Phone

(702) 518-1534

Fax

(702) 931-3944

NPI assigned

Mar 3, 2016

Last updated

Mar 3, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

GENESIS WOUNDCAREAs reported in NPPES

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

Authorized official

Name

James Thomas O'Dare III

Title

Prinicipal

Phone

(856) 335-5025

Specialties & licenses 4

Addresses

Locations

Practitioners 1

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.

• Anthony M Ricciardi, DPM

  • Podiatrist
  • Las Vegas, NV
  • NPI 1629087242
  NPD (past)

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1750741740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N ROUTE 73",
            "address_2": "SUITE A6",
            "city": "WEST BERLIN",
            "state": "NJ",
            "postal_code": "080919289",
            "telephone_number": "856-335-5025",
            "fax_number": "856-213-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 FIRE MESA ST",
            "address_2": "SUITE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891289016",
            "telephone_number": "702-518-1534",
            "fax_number": "702-931-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS WOUND CARE OF LAS VEGAS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESIS WOUNDCARE",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "O'DARE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRINICIPAL",
        "authorized_official_telephone_number": "856-335-5025",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genesis New Beginnings LLC
• Genesis Program LLC
• Genesis Rehab
• Genesis Rehab Services
• Genesis Solutions LLC
• Ariana Genilla
• Igor Genkin, MD
• Genlab Inc
• Payton Field Gennett
• Genoa Healthcare LLC

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.