Empowered Pain Primary and Urgent Care Center of Nevada LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

EMPOWERED PAIN PRIMARY AND URGENT CARE CENTER OF NEVADA LLC

Practice address

6465 W Sahara Ave Ste 103
Las Vegas, NV 89146-3071

Phone

(702) 822-1881

Fax

(702) 822-1880

NPI assigned

Feb 9, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Charles Russell

Title

Manager

Phone

(702) 787-9637

Specialties & licenses 9

Addresses

Other identifiers 2

Electronic endpoints 2

Locations

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1912599168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 W SAHARA AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463071",
            "telephone_number": "702-822-1881",
            "fax_number": "702-822-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 W SAHARA AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463071",
            "telephone_number": "702-822-1881",
            "fax_number": "702-822-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED PAIN PRIMARY AND URGENT CARE CENTER OF NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-09",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-787-9637",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA SECRETARY OF STATE",
            "identifier": "B202102081415526",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250018412",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PracticeFusion",
            "affiliation": "N",
            "endpointDescription": "PracticeFusion",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6465 W Sahara Ave Ste 103",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891463071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://r.search.yahoo.com/_ylt=AwrEzezW4Tdg3H4Ap4pXNyoA;_ylu=Y29sbwNiZjEEcG9zAzEEdnRpZAMEc2VjA3Nj/R",
            "affiliation": "N",
            "endpointDescription": "Practice Fusion",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6465 W Sahara Ave Ste 103",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891463071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Primary Care Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.