Axis Healthcare Clinics

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AXIS HEALTHCARE CLINICS

Practice address

4375 Las Vegas Blvd N Ste 9
Las Vegas, NV 89115-0587

Phone

(702) 410-5510

NPI assigned

Jul 15, 2021

Last updated

Jul 15, 2021By 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

Krista Huey

Title

Director of Operations

Phone

(702) 528-9947

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1912579103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071061",
            "telephone_number": "702-389-1148",
            "fax_number": "702-389-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 LAS VEGAS BLVD N STE 9",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891150587",
            "telephone_number": "702-410-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS HEALTHCARE CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "HUEY",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "702-528-9947"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100550403",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Socorro Ayala Carrera
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• Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.