Zane Medical Group LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ZANE MEDICAL GROUP LLC

Doing business as

Zane Behavioral Services
zane medical group llc

Practice address

3455 W Craig Rd Ste C
North Las Vegas, NV 89032-5119

Phone

(702) 802-2011

Fax

(702) 920-8226

NPI assigned

Oct 20, 2020

Organization subpart

No

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

Authorized official

Name

Sussan Sih FungNPI 1639649536

Title

Agent

Phone

(702) 802-2011

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Zane Behavioral Services Doing business as
• zane medical group llc Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sussan Fung

  • Counselor
  • North Las Vegas, NV
  • NPI 1639649536
  Medicare reassignment NPD Authorized official
• Nelson Jong Kwowi

  • Psychiatric/Mental Health Nurse Practitioner
  • North Las Vegas, NV
  • NPI 1689203853
  Medicare reassignment NPD
• Long Vu Tran, APRN

  • Nurse Practitioner
  • Las Vegas, NV
  • NPI 1821691429
  Medicare reassignment NPD
• Sharon Marjorie Tomlinson, PMHNP

  • Psychiatry Physician
  • Allen, TX
  • NPI 1386267466

  NV

  Medicare reassignment NPD
• Antoinette Romaine Lyons, LMFT-I

  • Marriage & Family Therapist
  • Las Vegas, NV
  • NPI 1205403664

  Multi-Specialty

  NPD
• Michelle Marie Morales, COMMUNITY HEALTH

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1457962714
  NPD
• Ashley Morgan, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Las Vegas, NV
  • NPI 1518553296
  NPD
• Vicky Salvador Keenan, MSW

  • Mental Health Counselor
  • Las Vegas, NV
  • NPI 1396336426
  NPD (past)

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1801495932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 W CRAIG RD STE C",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890325119",
            "telephone_number": "702-802-2011",
            "fax_number": "702-920-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 W CRAIG RD STE C",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890325119",
            "telephone_number": "702-802-2011",
            "fax_number": "702-920-8226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3376 S Eastern Ave Ste 148",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891693367",
            "country_code": "US",
            "telephone_number": "702-272-0025 x103",
            "fax_number": "702-920-8226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ZANE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "FUNG",
        "authorized_official_first_name": "SUSSAN",
        "authorized_official_middle_name": "SIH",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "702-802-2011"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250000654",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zane Behavioral Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "zane medical group llc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "zane medical group llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monica Zamora
• Rosa Zamora
• Socorro Zamora
• Samantha Zanca, RD, CSO, LD
• Zane Medical Group LLC
• By-Landa Zaragoza
• Darla Zarndt, D.O.
• Walfredo Zarraga, MD
• Dolores Maria Zavala
• Arcelia V Zavalza

• Primary Care Clinic/Center in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Primary Care Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.