Organization Active NPI

TDV LLC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1922891043
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TDV LLC
Practice address
2300 W Sahara Ave Ste 800
Las Vegas, NV 89102-4397
Phone
(725) 312-9003
Fax
(702) 922-3527
NPI assigned
May 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Hazel De Vera
Title
Manager
Phone
(725) 312-9003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2300 W Sahara Ave Ste 800
Las Vegas, NV 89102-4397

Mailing address

8241 Laredo St
Las Vegas, NV 89117-7649
Phone (725) 312-9003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250714003479 NV Part B Supplier - Clinic/Group Practice 3577078062 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1747872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1922891043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8241 LAREDO ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177649",
            "telephone_number": "725-312-9003",
            "fax_number": "702-922-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W SAHARA AVE STE 800",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891024397",
            "telephone_number": "725-312-9003",
            "fax_number": "702-922-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "DE VERA",
        "authorized_official_first_name": "HAZEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "725-312-9003"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.