NPIMap

Organization Active NPI

Southern Nevada Care Center

Doing business as Southern Nevada Medical and Behavioral Group

  • Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1801485131
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SOUTHERN NEVADA CARE CENTER
Doing business as
Southern Nevada Medical and Behavioral Group
Practice address
1330 Karen Ave Unit B
Las Vegas, NV 89169-1260
Phone
(702) 239-9235
Fax
(702) 947-2287
NPI assigned
Jan 12, 2021
Last updated
Feb 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Marichu Pizan, NPNPI 1497131668
Title
Ceo
Phone
(702) 239-9235

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1330 Karen Ave Unit B
Las Vegas, NV 89169-1260

Mailing address

8854 Carradori Ave
Las Vegas, NV 89148-4940
Phone (702) 239-9235

Other identifiers 1

IdentifierTypeStateIssuer
1801485131MedicaidNV

Other names 1

  • Southern Nevada Medical and Behavioral Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210201001385 NV Part B Supplier - Clinic/Group Practice 6507270667 Receives reassigned benefits from 8 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Southern Nevada Care Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

8879 W Flamingo Rd
Ste 106
Las Vegas, NV 89147
Phone (702) 625-0022

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

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": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1801485131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8854 CARRADORI AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484940",
            "telephone_number": "702-239-9235",
            "fax_number": "702-947-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 KAREN AVE UNIT B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891691260",
            "telephone_number": "702-239-9235",
            "fax_number": "702-947-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN NEVADA CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "PIZAN",
        "authorized_official_first_name": "MARICHU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-239-9235",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801485131",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Nevada Medical and Behavioral Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Nevada Medical and Behavioral Group",
            "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 Feb 18, 2021; 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.