Active NPI
Randa Bascharon D.O., Inc
- Orthopaedic Surgery Physician
- Las Vegas, NV
National Provider Identifier
1821032244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 1103
- Legal business name
- RANDA BASCHARON D.O., INC
- Practice address
- 500 E Windmill LN
# 125
Las Vegas, NV 89123-1843 - Phone
- (702) 947-7790
- Fax
- (702) 947-7792
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Randa Amin Bascharon, DO
- Title
- Pres Sec Etc
- Phone
- (702) 596-0036
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 1103 | NV | Primary |
| Orthopaedic Surgery Physician | 207X00000X | 20A8358 | CA | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 1103 | NV | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 20A8358 | CA |
Addresses
Primary practice location
500 E Windmill LN
# 125
Las Vegas, NV 89123-1843
Mailing address
4132 S Rainbow Blvd
#393
Las Vegas, NV 89103-3106
Phone (702) 596-0036
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| XTE006922 | Other | CA | CALIF MEDI-CAL |
| 100503044 | Medicaid | NV |
Other names 1
- ORTHOPEDIC & SPORTS MEDICINE INSTITUTE OF LAS VEGAS
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1269302400000",
"number": "1821032244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4132 S RAINBOW BLVD",
"address_2": "#393",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891033106",
"telephone_number": "702-596-0036",
"fax_number": "702-947-7792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E WINDMILL LN",
"address_2": "# 125",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891231843",
"telephone_number": "702-947-7790",
"fax_number": "702-947-7792"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RANDA BASCHARON D.O., INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-15",
"last_updated": "2010-03-23",
"status": "A",
"authorized_official_last_name": "BASCHARON",
"authorized_official_first_name": "RANDA",
"authorized_official_middle_name": "AMIN",
"authorized_official_title_or_position": "PRES SEC ETC",
"authorized_official_telephone_number": "702-596-0036",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "NV",
"license": "1103",
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "20A8358",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "NV",
"license": "1103",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "CA",
"license": "20A8358",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIF MEDI-CAL",
"identifier": "XTE006922",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100503044",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ORTHOPEDIC & SPORTS MEDICINE INSTITUTE OF LAS VEGAS",
"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 Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.