Individual provider Active NPI

Hava G Lavine, APN

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1972883320
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN001317 Issued in NV
Practice address
270 W Lake Mead Pkwy
Henderson, NV 89015-7093
Phone
(702) 617-1227
Fax
(702) 616-2069
NPI assigned
Aug 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN001317 NV Primary

Addresses

Primary practice location

270 W Lake Mead Pkwy
Henderson, NV 89015-7093

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 560-2900

Other identifiers 1

IdentifierTypeStateIssuer
1972883320MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111206000302 NV Practitioner - Nurse Practitioner 0042485823 Reassigns benefits to 2 organizations
I20180619001201 NY Practitioner - Nurse Practitioner 0042485823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (954) 939-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN001317NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Current Accepting new patients
Superior Emergency Physicians Harris, PLLC CurrentSince Dec 12, 2016 Accepting new patients
University Emergency Medical Services Inc. CurrentSince Apr 7, 2018 Accepting new patients
Shadow Emergency Physicians PLLC Nurse Practitioner CurrentSince May 23, 2018 Accepting new patients
Shadow Emergency Physicians PLLC Nurse Practitioner CurrentSince May 23, 2018 Accepting new patients
Dr. Terry D. Johnson, P.a. Past Accepting new patients

Locations

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

1409 E Lake Mead Blvd
North Las Vegas, NV 89030
Phone (702) 649-7711

275 Northpointe Pkwy
Ste 50
Buffalo, NY 14228
Phone (716) 389-3294

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

13737 Noel Rd
Ste 1600
Dallas, TX 75240
Phone (214) 712-2489

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1972883320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-560-2900",
            "fax_number": "702-560-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 W LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157093",
            "telephone_number": "702-617-1227",
            "fax_number": "702-616-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVINE",
        "first_name": "HAVA",
        "middle_name": "G",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APN001317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972883320",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.