NPIMap

Organization Active NPI

Optum Medical Services PC

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1780090381
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OPTUM MEDICAL SERVICES PC
Practice address
5060 S Fort Apache Rd
Suite 150
Las Vegas, NV 89148-1716
Phone
(877) 456-5506
NPI assigned
Jul 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Authorized official

Name
Dr. Ronald Shumacher, MD
Title
Officer
Phone
(952) 205-1189

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5060 S Fort Apache Rd
Suite 150
Las Vegas, NV 89148-1716

Mailing address

PO Box 692
Minneapolis, MN 55440-0692

Other names 1

  • Optum Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Optum Medical Services PC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404345600000",
    "number": "1780090381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 692",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 S FORT APACHE RD",
            "address_2": "SUITE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481716",
            "telephone_number": "877-456-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-03",
        "last_updated": "2014-07-03",
        "status": "A",
        "authorized_official_last_name": "SHUMACHER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "952-205-1189",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum Clinic",
            "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 Jul 3, 2014; 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.