Indigo Wellness

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

INDIGO WELLNESS

Practice address

4309 Snead Dr
Las Vegas, NV 89107-2070

Phone

(702) 913-3663

NPI assigned

May 2, 2019

Organization subpart

No

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

Authorized official

Name

James Carter

Title

Owner

Phone

(702) 913-3663

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Indigo Wellness Center Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1871158089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 SNEAD DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072070",
            "telephone_number": "702-913-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 SNEAD DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072070",
            "telephone_number": "702-913-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-913-3663"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06012620170",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "uagoldcarter@gmail.com",
            "affiliation": "N",
            "address_1": "4309 Snead Dr",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891072070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Indigo Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Indigo Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sohum Indharapu
• Indian Springs Community Services
• Indiana Signal Health Receivable Management
• Indigo Pharmaceutical LLC
• Indigo Supportive Services LLC.
• Indigo-Bane LLC
• Individual
• Individualized Internal Medicine
• Individualized Mindful Solutions LLC
• Priscilla Indome

• Mental Health Clinic/Center (Including Community Mental Health Center) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.