NPIMap

Organization Active NPI

Southern Nevada Health District

Doing business as Southern Nevada Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Las Vegas, NV
National Provider Identifier
1932745668
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHERN NEVADA HEALTH DISTRICT
Doing business as
Southern Nevada Community Health Center
Practice address
280 S Decatur Blvd
Las Vegas, NV 89107-2936
Phone
(702) 759-1686
NPI assigned
Nov 18, 2019
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Dr. Cassius Lockett
Title
District Heath Officer
Phone
(702) 759-1691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

280 S Decatur Blvd
Las Vegas, NV 89107-2936

Mailing address

280 S Decatur Blvd
Las Vegas, NV 89107-2936
Phone (702) 759-1000

Other practice location 1

2830 Fremont St
Las Vegas, NV 89104-2206
Phone (702) 759-1000

Other names 1

  • Southern Nevada Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191223001358 NV Part A Provider - Federally Qualified Health Center (FQHC) 3375542939 Practice locations: Las Vegas, NV
O20230124002814 NV Part A Provider - Federally Qualified Health Center (FQHC) 3375542939 Practice locations: Las Vegas, NV

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1932745668. Details of each certification follow.

Federally qualified health center certification: CCN 291867

Legal name
SOUTHERN NEVADA HEALTH DISTRICT
Doing business as
SOUTHERN NEVEDA COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 14, 2020
Last certification
Jan 14, 2020
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Incorporated
Jul 1, 1986 in NV
Enrollment address
280 S Decatur Blvd
Las Vegas, NV 89107-2936

Federally qualified health center certification: CCN 291007

Legal name
SOUTHERN NEVADA HEALTH DISTRICT
Doing business as
SOUTHERN NEVADA COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 27, 2022
Last certification
Dec 27, 2022
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
2830 Fremont St
Las Vegas, NV 89104-2206

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Southern NV Health District5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4201 W Washington Ave
Las Vegas, NV 89107
Phone (702) 759-1000

560 N Nellis Blvd
Ste E1
Las Vegas, NV 89110
Phone (702) 759-1000

700 S Martin L King Blvd
Las Vegas, NV 89106
Phone (702) 759-1000

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cassius Lockett Individual Contracted Managing EmployeeMD; Mar 3, 2025 100%
Corporate Director Mar 3, 2025 100%
W-2 Managing Employee Mar 3, 2025 100%
Operational/Managerial Control Mar 3, 2025 100%
Contracted Managing Employee Mar 3, 2025
Corporate Director Mar 3, 2025
Operational/Managerial Control Mar 3, 2025
Southern Nevada Health District Organization, Las Vegas, NV Corporation 5% Or Greater Direct Ownership Interest Dec 3, 1978 100%
Angel Jimenez Individual Operational/Managerial Control Jan 1, 2025
Fermin Leguen Individual Corporate DirectorAssistant Director Health Office Aug 1, 2016 100%
W-2 Managing EmployeeAssistant Director Health Office Aug 1, 2016 100%
Operational/Managerial Control Jan 10, 2020 100%
Contracted Managing Employee Aug 1, 2016
Corporate Officer Aug 1, 2016
Donna Buss Individual Operational/Managerial Control Aug 23, 2021
Contracted Managing Employee Mar 3, 2022
Corporate Officer Mar 3, 2022

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1932745668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072936",
            "telephone_number": "702-759-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072936",
            "telephone_number": "702-759-1686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2830 Fremont St",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891042206",
            "country_code": "US",
            "telephone_number": "702-759-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN NEVADA HEALTH DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "LOCKETT",
        "authorized_official_first_name": "CASSIUS",
        "authorized_official_title_or_position": "DISTRICT HEATH OFFICER",
        "authorized_official_telephone_number": "702-759-1691",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Nevada Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Nevada Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.