Organization Active NPI

Salty Light LLC

  • Family Medicine Physician
  • Henderson, NV
National Provider Identifier
1912898701
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SALTY LIGHT LLC
Doing business as
Salt & Light Medical Center
Practice address
1477 E Lake Mead Pkwy Ste 130
Henderson, NV 89015-4647
Phone
(725) 726-2364
NPI assigned
Jul 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Heather Clawson
Title
Office Administrator
Phone
(725) 726-2364

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

1477 E Lake Mead Pkwy Ste 130
Henderson, NV 89015-4647

Mailing address

1477 E Lake Mead Pkwy Ste 130
Henderson, NV 89015-4647
Phone (725) 726-2364

Other names 1

  • Salt & Light Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251009003742 NV Part B Supplier - Clinic/Group Practice 2062919475 Receives reassigned benefits from 1 practitioner
Practice locations: Henderson, NV

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGHIDD

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1912898701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 E LAKE MEAD PKWY STE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890154647",
            "telephone_number": "725-726-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 E LAKE MEAD PKWY STE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890154647",
            "telephone_number": "725-726-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALTY LIGHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "CLAWSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "725-726-2364"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt & Light Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.