Individual provider Active NPI

Xiaokun Montez, M.D, PHD

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1801867668
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
14576 Issued in NV
Practice address
10105 Banburry Cross Drive
Suite 370
Las Vegas, NV 89144-6649
Phone
(702) 260-4525
Fax
(702) 869-0133
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200500963 NC
Pediatrics Physician 208000000X 14576 NV Primary

Addresses

Primary practice location

10105 Banburry Cross Drive
Suite 370
Las Vegas, NV 89144-6649

Mailing address

10105 Banburry Cross Drive
Suite 370
Las Vegas, NV 89144-6649
Phone (702) 260-4525

Other identifiers 1

IdentifierTypeStateIssuer
5901128MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
033WYMDClinical Social Worker
200500963NCMDPediatrics Physician
14576NVMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1801867668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10105 BANBURRY CROSS DRIVE",
            "address_2": "SUITE 370",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446649",
            "telephone_number": "702-260-4525",
            "fax_number": "702-869-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10105 BANBURRY CROSS DRIVE",
            "address_2": "SUITE 370",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446649",
            "telephone_number": "702-260-4525",
            "fax_number": "702-869-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEZ",
        "first_name": "XIAOKUN",
        "credential": "M.D, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200500963",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "14576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901128",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.