NPIMap

Organization Active NPI

Smfmc LLC

Doing business as Sunrise Mountain Family Medical Clinic

  • Primary Care Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1801501689
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
SMFMC LLC
Doing business as
Sunrise Mountain Family Medical Clinic
Practice address
4840 E. Bonanza Rd
Suite 8
Las Vegas, NV 89110
Phone
(725) 204-1008
Fax
(725) 204-5877
NPI assigned
Jan 17, 2023
Last updated
Jan 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Joan Dawn Galang, NPNPI 1407204035
Title
NP-Owner
Phone
(725) 204-1008

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
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

4840 E. Bonanza Rd
Suite 8
Las Vegas, NV 89110

Mailing address

4840 E. Bonanza Rd
Suite. 8
Las Vegas, NV 89110
Phone (725) 204-1008

Other names 1

  • Sunrise Mountain Family Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230412002340 NV Part B Supplier - Clinic/Group Practice 8628443280 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1801501689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 E. BONANZA RD",
            "address_2": "SUITE. 8",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89110",
            "telephone_number": "725-204-1008",
            "fax_number": "725-204-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 E. BONANZA RD",
            "address_2": "SUITE 8",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89110",
            "telephone_number": "725-204-1008",
            "fax_number": "725-204-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMFMC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "GALANG",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "NP-OWNER",
        "authorized_official_telephone_number": "725-204-1008",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Mountain Family Medical 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 Jan 17, 2023; 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.