Organization Active NPI

Tannoury MD PC

Doing business as Primary Care Center of Nevada

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1992162606
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8820 Issued in NV
Legal business name
TANNOURY MD PC
Doing business as
Primary Care Center of Nevada
Practice address
2001 S Rainbow Blvd
Las Vegas, NV 89146-2990
Phone
(702) 315-4600
Fax
(702) 315-4607
NPI assigned
Jan 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Authorized official

Name
Dr. Georges Youssef Tannoury, MDNPI 1639143423
Title
Owner
Phone
(702) 510-5447

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 12311 NV
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 8820 NV Primary

Addresses

Primary practice location

2001 S Rainbow Blvd
Las Vegas, NV 89146-2990

Mailing address

3144 Beach View CT
Las Vegas, NV 89117-3531
Phone (702) 510-5447

Other names 1

  • Primary Care Center of Nevada Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160301000601 NV Part B Supplier - Clinic/Group Practice 7416252416 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2001 S Rainbow Blvd
Las Vegas, NV 89146
Phone (702) 315-4600

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1992162606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3144 BEACH VIEW CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891173531",
            "telephone_number": "702-510-5447",
            "fax_number": "702-684-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891462990",
            "telephone_number": "702-315-4600",
            "fax_number": "702-315-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANNOURY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "TANNOURY",
        "authorized_official_first_name": "GEORGES",
        "authorized_official_middle_name": "YOUSSEF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-510-5447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "12311",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "8820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Center of Nevada",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.