Integrated Medical Clinic LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

INTEGRATED MEDICAL CLINIC LLC

Practice address

501 S Rancho Dr Ste F38
Las Vegas, NV 89106-4834

Phone

(323) 347-0008

NPI assigned

Apr 11, 2025

Last updated

Jul 16, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Chinenye Godwin, NPNPI 1699305839

Title

Owner

Phone

(323) 347-0008

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Samuel C Godwin, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
  • NPI 1699305839
  NPD Authorized official

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

{
    "created_epoch": "1744329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1811782584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S RANCHO DR STE F38",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064834",
            "telephone_number": "323-347-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S RANCHO DR STE F38",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064834",
            "telephone_number": "323-347-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-11",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "CHINENYE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-347-0008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.