MVP Primary Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MVP PRIMARY CARE LLC

Practice address

6935-104 Aliante Parkway
#509
North Las Vegas, NV 89084

Phone

(702) 518-8831

Fax

(702) 675-7789

NPI assigned

Feb 9, 2017

Organization subpart

No

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

Authorized official

Name

Andrew Patrick, FNPNPI 1932369337

Title

Owner

Phone

(702) 672-8042

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

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

• Andrew W Patrick, APN

  • Nurse Practitioner
  • Las Vegas, NV
  • NPI 1932369337
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1871031906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6935-104 ALIANTE PARKWAY",
            "address_2": "#509",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89084",
            "telephone_number": "702-518-8831",
            "fax_number": "702-675-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6935-104 ALIANTE PARKWAY",
            "address_2": "#509",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89084",
            "telephone_number": "702-518-8831",
            "fax_number": "702-675-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MVP PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-672-8042",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.