Nevada Health Centers, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Amargosa Valley, NV
NPI 1831278720 · NPPES record last updated Feb 5, 2020
Key facts
- NPI
- 1831278720
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 291803 (NV)
- Legal business name
- NEVADA HEALTH CENTERS, INC.
- Practice address
- 1690 E Amargosa Farm Rd
Amargosa Valley, NV 89020-9735 - Phone
- (775) 372-5432
- Fax
- (775) 372-1303
- NPI assigned
- Nov 3, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- NEVADA HEALTH CENTERS, INC.
Authorized official
- Name
- Walter B Davis
- Title
- Ceo
- Phone
- (775) 888-6610
Owned or controlled facilities with NPI records 14
Other NPIs on the same Medicare enrollment 34
Other NPIs with the same Medicare PAC ID 24
Practitioners 41
-
Gayle Harris, APRN
-
Steven H Cerna, APRN
-
Madelaine Heidi Coquelet-Meyer, MFT, LCADC
-
Sarah Draves, APRN
-
Ashwitha Francis, MD
-
Rachel Elizabeth Grant, FNP-C
-
Amanda Lauren Horton, APRN
-
Mylinda Barrick Houser, LCSW
-
Sandra Fay Lewis, LCSW
-
Steve Lore, MD
-
Karina J Luera, DO
-
Elyse Muratore, MD
-
Ertha A Nanton, MD
-
Michael W Owens, MD
-
Amol Patel, MD
-
Rhianna Michelle Perez, MSN, FNP-C
-
Darren A Rahaman, MD
-
Jill Rathie, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV
Federally qualified health center certification: CCN 291803
- Legal name
- NEVADA HEALTH CENTERS INC
- Doing business as
- AMARGOSA VALLEY MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 1, 1991
- Last certification
- Oct 1, 1991
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 22, 1992 in NV
- Enrollment address
- 1690 E Amargosa Farm Rd
Amargosa Valley, NV 89020-9735
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Donald E Chaney |
Corporate Director |
Aug 1, 2012 | |
| Alicia Y Barnes |
Corporate Director |
Aug 1, 2012 | |
| Gerald Ackerman |
Corporate Director |
Mar 1, 2011 | |
| Linda Bingaman |
Corporate Director |
May 15, 2015 | |
| Kathryn L Triplett |
Corporate Officer |
Oct 1, 2016 | 100% |
| W-2 Managing Employee |
Oct 1, 2016 | 100% | |
| Maurice Washington |
Corporate Director |
May 15, 2015 | |
| Jared Carter |
Corporate Director |
Jun 5, 2009 | |
| Adriana Fralick |
Corporate Director |
May 15, 2015 | |
| Walter B Davis |
Corporate Officer |
Nov 26, 2012 | 100% |
| W-2 Managing Employee |
Nov 26, 2012 | 100% |
All facility ownership & control disclosures 14
| Facility | Type | Role | Since |
|---|---|---|---|
| Cambridge Family Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 1, 2013 |
| North Las Vegas Family Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | May 3, 2013 |
| Eastern Family Medical and Dental Center |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 2010 |
| Jackpot Community Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 1999 |
| Henderson Family Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 18, 2015 |
| Nevada Health Centers Carson City School Based |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 21, 2015 |
| Nevada Health Centers at Virginia City |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 29, 2015 |
| Nevada Children'S Health Project |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 26, 2018 |
| Nevada Health Centers at Enterprise |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | May 10, 2019 |
| Willow Street Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 22, 2023 |
| Mobile Medical Services 1 |
Federally qualified health center | 5% Or Greater Direct Ownership Interest | Dec 29, 2023 |
| Mobile Dental Services 1 |
Federally qualified health center | 5% Or Greater Indirect Ownership Interest | Dec 1, 2023 |
| Nellis Family Medical & Dental Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 9, 2024 |
| Pahrump Family Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 8, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040219000452 | NV | Part B Supplier - Clinic/Group Practice | 7113835307 |
Receives reassigned benefits from 65 practitioners 34 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Las Vegas, NV; North Las Vegas, NV; Pahrump, NV; Reno, NV; Virginia City, NV; West Wendover, NV; Amargosa Valley, NV; Austin, NV… |
| O20080529000446 | NV | Part a Provider - Federally Qualified Health Center (FQHC) | 7113835307 | Practice locations: Amargosa Valley, NV |
National Provider Directory
- Part of
- Nevada Rural Health Cen
Locations
1690 E Amargosa Farm Rd
Amargosa Valley, NV 89020
Phone (775) 372-5432
845 E Farm Rd
#69
Amargosa Valley, NV 89020
Phone (775) 372-5432
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 291803 | NV | Yes |
Addresses
Primary practice location
1690 E Amargosa Farm Rd
Amargosa Valley, NV 89020-9735
Mailing address
3325 Research Way
Attn: Pat
Carson City, NV 89706-7913
Phone (775) 888-6610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DQ468D | Other | NV | MEDICARE ID-TYPE UNSPECIFIED |
| 1831278720 | Medicaid | NV |
Other names
- Amargosa Valley Medical Clinic
Other providers in Amargosa Valley, NV
- Ferdinand Rayco Madayag
- Amy Manke
- Tim Manke
- Cody Murphy
- Nevada Health Centers, Inc.
- Never Give Up Residential LLC
- New Benchmark
- Northwest Associates Psychological LLC
- Northwest Associates Psychological LLC
- Northwest Associates Psychological LLC
All providers in Amargosa Valley, NV · Federally Qualified Health Center (FQHC) in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.