NPIMap

Organization Active NPI

American Family Healthcare Center

  • Primary Care Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1972195220
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
AMERICAN FAMILY HEALTHCARE CENTER
Practice address
4200 W Charleston Blvd BLDG a
Las Vegas, NV 89102-1625
Phone
(970) 208-6767
NPI assigned
Feb 8, 2021
Last updated
Feb 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Authorized official

Name
Jun Chen Clegg
Title
Owner
Phone
(970) 208-6767

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WW0000X
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X
Interventional Cardiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0011X
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X
Certified Respiratory TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 227800000X
Primary Care Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

4200 W Charleston Blvd BLDG a
Las Vegas, NV 89102-1625

Mailing address

4200 W Charleston Blvd BLDG a
Las Vegas, NV 89102-1625
Phone (970) 208-6767

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1972195220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W CHARLESTON BLVD BLDG A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021625",
            "telephone_number": "970-208-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W CHARLESTON BLVD BLDG A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021625",
            "telephone_number": "970-208-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN FAMILY HEALTHCARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "CLEGG",
        "authorized_official_first_name": "JUN",
        "authorized_official_middle_name": "CHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-208-6767"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "227800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Respiratory Therapist, Certified",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "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 Feb 8, 2021; 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.