Active NPI
North Las Vegas Behavioral Health
- Psychiatry Physician
- North Las Vegas, NV
National Provider Identifier
1871090498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- NORTH LAS VEGAS BEHAVIORAL HEALTH
- Practice address
- 3131 W Craig Rd Ste 180
North Las Vegas, NV 89032 - Phone
- (702) 586-5999
- Fax
- (702) 586-5991
- NPI assigned
- Apr 10, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kirk A Wan
- Title
- Ceo
- Phone
- (702) 586-5999
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary | ||
| Multi-Specialty Clinic/Center | 261QM1300X | NV20151645220 | NV |
Addresses
Primary practice location
3131 W Craig Rd Ste 180
North Las Vegas, NV 89032
Mailing address
3131 W Craig Rd Ste 180
North Las Vegas, NV 89032-0861
Phone (702) 586-5999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578935508 | Medicaid | NV |
National Provider Directory
National Provider Directory- Tax ID family
- North Las Vegas Behavioral Health
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Substance Abuse Rehabilitation Facility
- North Las Vegas, NV
- NPI 1538650577
-
- Community/Behavioral Health Agency
- North Las Vegas, NV
- NPI 1578935508
-
- Adult Day Care Clinic/Center
- North Las Vegas, NV
- NPI 1679068589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523318400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529539200000",
"number": "1871090498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3131 W CRAIG RD STE 180",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890320861",
"telephone_number": "702-586-5999",
"fax_number": "702-586-5991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 W CRAIG RD STE 180",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "89032",
"telephone_number": "702-586-5999",
"fax_number": "702-586-5991"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH LAS VEGAS BEHAVIORAL HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2018-04-10",
"last_updated": "2018-06-21",
"status": "A",
"authorized_official_last_name": "WAN",
"authorized_official_first_name": "KIRK",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "702-586-5999",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "NV",
"license": "NV20151645220",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1578935508",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}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 Jun 21, 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.