NPIMap

Organization Active NPI

Summit Integrated Health of NLV

  • Family Nurse Practitioner
  • North Las Vegas, NV
National Provider Identifier
1801464110
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SUMMIT INTEGRATED HEALTH OF NLV
Practice address
2590 Nature Park Dr Ste 135
North Las Vegas, NV 89084-3187
Phone
(702) 636-2843
Fax
(702) 726-9543
NPI assigned
Jun 14, 2021
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Ms. Gennie M Budet
Title
Billing/Credentialing
Phone
(702) 462-9729

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 171400000X
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X
Medical Specialty Clinic/Center 261QM2500X
Durable Medical Equipment & Medical Supplies 332B00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2590 Nature Park Dr Ste 135
North Las Vegas, NV 89084-3187

Mailing address

3222 E Viking Rd
Las Vegas, NV 89121-4318

Other practice location 1

2670 Crimson Canyon Dr Ste 150
Las Vegas, NV 89128-0848
Phone (702) 232-3189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210723000332 NV Part B Supplier - Clinic/Group Practice 9931502382 Receives reassigned benefits from 9 practitioners
Practice locations: Las Vegas, NV; Henderson, NV; North Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Summit Integrated Health of2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3037 W Horizon Ridge Pkwy
Ste 110
Henderson, NV 89052
Phone (702) 216-7496

7220 S Cimarron Rd
Ste 140
Las Vegas, NV 89113
Phone (702) 636-2843

2590 Nature Park Dr
North Las Vegas, NV 89084

2590 Nature Park Dr
Ste 135
North Las Vegas, NV 89084
Phone (702) 636-2843

Practitioners & affiliated clinicians

Practitioners 10

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": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1801464110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3222 E VIKING RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891214318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2590 NATURE PARK DR STE 135",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890843187",
            "telephone_number": "702-636-2843",
            "fax_number": "702-726-9543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2670 Crimson Canyon Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280848",
            "country_code": "US",
            "telephone_number": "702-232-3189",
            "fax_number": "702-726-9543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUMMIT INTEGRATED HEALTH OF NLV",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "BUDET",
        "authorized_official_first_name": "GENNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING",
        "authorized_official_telephone_number": "702-462-9729",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North 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 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.