NPIMap

Organization Active NPI

Mytelemdusa LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • North Las Vegas, NV
National Provider Identifier
1831783141
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MYTELEMDUSA LLC
Practice address
1703 Civic Center Dr Ste 6
North Las Vegas, NV 89030-7273
Phone
(702) 874-4448
Fax
(702) 848-2809
NPI assigned
Feb 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Salina Ramirez
Title
Admin
Phone
(702) 874-4448

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1703 Civic Center Dr Ste 6
North Las Vegas, NV 89030-7273

Mailing address

1703 Civic Center Dr Ste 6
North Las Vegas, NV 89030-7273
Phone (702) 874-4448

Other names 1

  • Inner Healing Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NorthLasVegas

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211122000242 NV Part B Supplier - Clinic/Group Practice 9234528829 Receives reassigned benefits from 7 practitioners
Practice locations: North Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

4425 S Jones Blvd
Ste 2
Las Vegas, NV 89103

Practitioners & affiliated clinicians

Practitioners 7

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": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1831783141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 CIVIC CENTER DR STE 6",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307273",
            "telephone_number": "702-874-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 CIVIC CENTER DR STE 6",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307273",
            "telephone_number": "702-874-4448",
            "fax_number": "702-848-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYTELEMDUSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-26",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "SALINA",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "702-874-4448"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NorthLasVegas",
            "affiliation": "N",
            "address_1": "1703 Civic Center Dr Ste 2",
            "city": "North Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890307273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Inner Healing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.