NPIMap

Organization Active NPI

Elite Medicdal Services

  • Health Service Clinic/Center
  • Henderson, NV
National Provider Identifier
1952539751
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
1006266151 Issued in NV
Legal business name
ELITE MEDICDAL SERVICES
Practice address
2779 Sunridge Heights Pkwy
Henderson, NV 89052-5050
Phone
(702) 565-9355
Fax
(702) 478-5480
NPI assigned
Jun 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Simong Youmans, MD
Title
Owner
Phone
(702) 565-9355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 1006266151 NV Primary

Addresses

Primary practice location

2779 Sunridge Heights Pkwy
Henderson, NV 89052-5050

Mailing address

2779 Sunridge Heights Pkwy
Henderson, NV 89052-5050

Other identifiers 1

IdentifierTypeStateIssuer
1124129655OtherNVNPI

National Provider Directory

National Provider Directory
Tax ID family
Elite Med Spa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2779 Sunridge Heights Pkwy
Henderson, NV 89052
Phone (702) 248-7337

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1952539751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2779 SUNRIDGE HEIGHTS PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525050",
            "fax_number": "702-478-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2779 SUNRIDGE HEIGHTS PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525050",
            "telephone_number": "702-565-9355",
            "fax_number": "702-478-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICDAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "YOUMANS",
        "authorized_official_first_name": "SIMONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-565-9355",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NV",
            "license": "1006266151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124129655",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 30, 2009; 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.