Nevada Health Centers, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Las Vegas, NV
NPI 1780831925 · NPPES record last updated May 7, 2015
Key facts
- NPI
- 1780831925
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 291837 (NV)
- Legal business name
- NEVADA HEALTH CENTERS, INC.
- Practice address
- 2212 S Eastern Ave
Las Vegas, NV 89104-4124 - Phone
- (702) 735-9334
- Fax
- (702) 735-9335
- NPI assigned
- Aug 19, 2008
- Organization subpart
- No
Authorized official
- Name
- Walter B Davis
- Title
- Ceo
- Phone
- (775) 888-6610
Owners & managing parties with NPI records 24
Owned or controlled facilities with NPI records 13
Other NPIs on the same Medicare enrollment 34
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 33
Facilities with the same owner 13
Practitioners 40
-
Haran Ravindran, MD
-
Skyler Levere Arnold, APRN
-
Steven H Cerna, APRN
-
Madelaine Heidi Coquelet-Meyer, MFT, LCADC
-
Sarah Draves, APRN
-
Ashwitha Francis, MD
-
Rachel Elizabeth Grant, FNP-C
-
Gayle Harris, APRN
-
Amanda Lauren Horton, APRN
-
Mylinda Barrick Houser, LCSW
-
Sandra Fay Lewis, LCSW
-
Steve Lore, MD
-
Karina J Luera, DO
-
Elyse Muratore, MD
-
Ertha A Nanton, MD
-
Michael W Owens, MD
-
Amol Patel, MD
-
Rhianna Michelle Perez, MSN, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV
Federally qualified health center certification: CCN 291837
- Legal name
- NEVADA HEALTH CENTERS INC
- Doing business as
- EASTERN FAMILY MEDICAL AND DENTAL CENTER
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 22, 1992 in NV
- Enrollment address
- 2212 S Eastern Ave
Las Vegas, NV 89104-4124
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Paula C Moore |
Corporate Director |
May 1, 2025 | |
| Wendy Charlebois |
Corporate Director |
May 1, 2025 | |
| Timothy Blakely |
Corporate Director |
Jun 1, 2018 | |
| Lyn Beggs |
Corporate Director |
Jun 1, 2022 | |
| Jeff Snyder |
Corporate Director |
Jun 1, 2016 | |
| Tom Zumtobel |
Corporate Director |
Jun 1, 2022 | |
| Linda Bingaman |
Corporate Director |
May 15, 2015 | |
| Kathryn L Triplett |
Corporate Officer |
Oct 1, 2016 | 50% |
| W-2 Managing Employee |
Oct 1, 2016 | 50% | |
| Nevada Health Centers Inc |
Operational/Managerial Control | Jun 29, 2010 | 100% |
| Maurice Washington |
Corporate Director |
May 15, 2015 | |
| Nicola Aaker |
Corporate Director |
May 1, 2025 | |
| Richard Luman |
Corporate Director |
May 1, 2025 | |
| Elizabeth Esteves |
W-2 Managing Employee |
Jun 10, 2024 | |
| Lisbeth Soriano |
Corporate Director |
May 1, 2025 | |
| Walter B Davis |
Corporate Officer |
Nov 26, 2012 | 50% |
| W-2 Managing Employee |
Nov 26, 2012 | 50% |
All facility ownership & control disclosures 13
| Facility | Type | Role | Since |
|---|---|---|---|
| Cambridge Family Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 1, 2013 |
| North Las Vegas Family Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | May 3, 2013 |
| Jackpot Community Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 1999 |
| Henderson Family Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 18, 2015 |
| Nevada Health Centers Carson City School Based |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 21, 2015 |
| Nevada Health Centers at Virginia City |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 29, 2015 |
| Nevada Children'S Health Project |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 26, 2018 |
| Nevada Health Centers at Enterprise |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | May 10, 2019 |
| Willow Street Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 22, 2023 |
| Mobile Medical Services 1 |
Federally qualified health center | 5% Or Greater Direct Ownership Interest | Dec 29, 2023 |
| Mobile Dental Services 1 |
Federally qualified health center | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 |
| Nellis Family Medical & Dental Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 9, 2024 |
| Pahrump Family Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 8, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040219000452 | NV | Part B Supplier - Clinic/Group Practice | 7113835307 |
Receives reassigned benefits from 65 practitioners 34 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Las Vegas, NV; North Las Vegas, NV; Pahrump, NV; Reno, NV; Virginia City, NV; West Wendover, NV; Amargosa Valley, NV; Austin, NV… |
| O20100626000516 | NV | Part a Provider - Federally Qualified Health Center (FQHC) | 7113835307 | Practice locations: Las Vegas, NV |
National Provider Directory
- Tax ID family
- Nevada Rural Health Cen
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 291837 | NV | Yes |
Addresses
Primary practice location
2212 S Eastern Ave
Las Vegas, NV 89104-4124
Mailing address
3325 Research Way
Carson City, NV 89706-7913
Phone (775) 888-6610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780831925 | Medicaid | NV |
Other names
- Eastern Family Medical and Dental Center
Other providers in Las Vegas, NV
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- Nevada Health Centers Inc.
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- Nevada Health Centers, Inc.
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- Nevada Health Centers, Inc.
- Nevada Health Centers, Inc.
- Nevada Health Centers, Inc.
- Nevada Health Line Plus LTD.
- Nevada Health RX Inc
All providers in Las Vegas, NV · Federally Qualified Health Center (FQHC) in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.