NPIMap

Organization Active NPI

Piceno Kidney & Hypertension Specialists, LLC

  • Nephrology Physician
  • Las Vegas, NV
National Provider Identifier
1831528637
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
14024 Issued in NV
Legal business name
PICENO KIDNEY & HYPERTENSION SPECIALISTS, LLC
Practice address
3121 S Maryland Pkwy Ste 412
Las Vegas, NV 89109
Phone
(702) 997-4250
NPI assigned
Nov 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Authorized official

Name
Michelle Wendl
Title
Administrator / Ao
Phone
(702) 407-8241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 14024 NV Primary

Addresses

Primary practice location

3121 S Maryland Pkwy Ste 412
Las Vegas, NV 89109

Mailing address

PO Box 778435
Henderson, NV 89077-8435
Phone (702) 818-9246

Other practice location 1

600 Whitney Ranch Dr
Unit B 11
Henderson, NV 89014-2611
Phone (702) 818-9246

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1831528637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778435",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890778435",
            "telephone_number": "702-818-9246",
            "fax_number": "702-492-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 S MARYLAND PKWY STE 412",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89109",
            "telephone_number": "702-997-4250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Whitney Ranch Dr",
            "address_2": "Unit B 11",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890142611",
            "country_code": "US",
            "telephone_number": "702-818-9246",
            "fax_number": "702-492-1728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PICENO KIDNEY & HYPERTENSION SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "WENDL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR / AO",
        "authorized_official_telephone_number": "702-407-8241"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "14024",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 25, 2018; 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.