Dynamic Medical Group LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DYNAMIC MEDICAL GROUP LLC

Practice address

3841 W Charleston Blvd Ste 202
Las Vegas, NV 89102-1858

Phone

(702) 623-7990

Fax

(702) 623-5033

NPI assigned

Apr 26, 2023

Last updated

Apr 26, 2023By 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

Jessica Erfe, RN

Title

Administrator

Phone

(702) 704-9611

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 9

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.

• Jayson Lintag Bautista, APRN

  • Family Nurse Practitioner
  • Henderson, NV
  • NPI 1023776309
  Medicare reassignment Care Compare group NPD
• John Rendell Saulog Caldejon

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1568295954
  Medicare reassignment Care Compare group NPD
• Michael Joseph Mapoy Isada

  • Nurse Practitioner
  • Las Vegas, NV
  • NPI 1497597298
  Medicare reassignment Care Compare group NPD
• Darren Julius Ramos Nool, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1942042403
  Medicare reassignment Care Compare group NPD
• Jee Jean Tolentino Dykheng, FNP-C

  • Family Nurse Practitioner
  • Winnetka, CA
  • NPI 1386477115

  NV

  Medicare reassignment Care Compare group NPD
• Christopher L Igtiben, MD

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1194085308
  Medicare reassignment NPD
• Airen B Briceno, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1154056976
  Medicare reassignment
• Victor Shawn Ingram, LCSW

  • Clinical Social Worker
  • Nellis AFB, NV
  • NPI 1043745557
  NPD
• Diana Lynn Subero

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1326342676
  NPD

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1841988136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 W CHARLESTON BLVD STE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021858",
            "telephone_number": "702-623-7990",
            "fax_number": "702-623-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 W CHARLESTON BLVD STE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021858",
            "telephone_number": "702-623-7990",
            "fax_number": "702-623-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "ERFE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-704-9611",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "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": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynamic Familiy Therapies LLC (Dynamic Family Therapies)
• Dynamic Family Therapies
• Dynamic Future LLC
• Dynamic Home Health Care LLC
• Dynamic Integrative Solutions
• Dynamic Medical Systems, Inc.
• Dynamic Minds Family Services
• Dynamic Minds Family Services LLC
• Dynamic Spine & Sport Rehabilitation LLC
• Dynamic Urgent Care

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.