NPIMap

Organization Active NPI

Independent Medical Group, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Pahrump, NV
National Provider Identifier
1942843859
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
INDEPENDENT MEDICAL GROUP, LLC
Practice address
1320 E Calvada Blvd
Pahrump, NV 89048-5692
Phone
(775) 751-6111
Fax
(775) 751-3056
NPI assigned
Oct 23, 2019
Last updated
Dec 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Authorized official

Name
Dr. Michael D. Reiner, MDNPI 1285698381
Title
Manager
Phone
(775) 751-6111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

1320 E Calvada Blvd
Pahrump, NV 89048-5692

Mailing address

PO Box 1309
Pahrump, NV 89041-1309
Phone (775) 751-6111

Other identifiers 1

IdentifierTypeStateIssuer
2012042MedicaidNV

National Provider Directory

National Provider Directory

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": "1571788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576195200000",
    "number": "1942843859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890411309",
            "telephone_number": "775-751-6111",
            "fax_number": "775-751-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 E CALVADA BLVD",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890485692",
            "telephone_number": "775-751-6111",
            "fax_number": "775-751-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A",
        "authorized_official_last_name": "REINER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "775-751-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2012042",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahrump, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.