NPIMap

Organization Active NPI

Andrea E Pernell MD PC

  • Physical Medicine & Rehabilitation Physician
  • Las Vegas, NV
National Provider Identifier
1851670178
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ANDREA E PERNELL MD PC
Practice address
2810 W Charleston Blvd
Suite 48
Las Vegas, NV 89102-1921
Phone
(702) 870-2213
Fax
(702) 362-2463
NPI assigned
Aug 4, 2011
Last updated
Dec 31, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Authorized official

Name
Andrea Pernell, MDNPI 1053301580
Title
President
Phone
(702) 279-0765

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X NV Primary

Addresses

Primary practice location

2810 W Charleston Blvd
Suite 48
Las Vegas, NV 89102-1921

Mailing address

PO Box 400205
Las Vegas, NV 89140-0205
Phone (702) 870-2213

National Provider Directory

National Provider Directory

Locations

2810 W Charleston Blvd
Ste 48
Las Vegas, NV 89102
Phone (701) 870-2213

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388448000000",
    "number": "1851670178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891400205",
            "telephone_number": "702-870-2213",
            "fax_number": "702-870-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 W CHARLESTON BLVD",
            "address_2": "SUITE 48",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021921",
            "telephone_number": "702-870-2213",
            "fax_number": "702-362-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA E PERNELL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-04",
        "last_updated": "2013-12-31",
        "status": "A",
        "authorized_official_last_name": "PERNELL",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-279-0765",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NV",
            "license": null,
            "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 Dec 31, 2013; 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.