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DIGNITY HEALTH MEDICAL GROUP NEVADA LLC
Complete NPI Record 1326558610
Internal Medicine - Rheumatology in Henderson, NV

NPI Status: Active since October 02, 2017

Contact Information

10001 S EASTERN AVE STE 203
HENDERSON, NV
ZIP 89052
Phone: (702) 616-5801

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider First Line Business Practice Location Address
  11. Provider Business Practice Location Address City Name
  12. Provider Business Practice Location Address State Name
  13. Provider Business Practice Location Address Postal Code
  14. Provider Business Practice Location Address Country Code If outside U S
  15. Provider Business Practice Location Address Telephone Number
  16. Provider Enumeration Date
  17. Last Update Date
  18. Authorized Official Last Name
  19. Authorized Official First Name
  20. Authorized Official Title or Position
  21. Authorized Official Telephone Number
  22. Healthcare Provider Taxonomy Code 1
  23. Healthcare Provider Primary Taxonomy Switch 1
  24. Is Organization Subpart
  25. Healthcare Provider Taxonomy Group 1

Complete NPI Dataset

This page represents the complete record for NPI 1326558610. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1326558610
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Employer Identification Number EIN: UNAVAIL
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Provider First Line Business Mailing Address: 2200 PASEO VERDE PKWY STE 260
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: HENDERSON
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NV
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 890522703
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 10001 S EASTERN AVE STE 203
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: HENDERSON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NV
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 890523908
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7026165801
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 10/2/2017
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 10/2/2017
The date that a record was last updated or changed.
Authorized Official Last Name: WALKER
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: MELISSA
The first name of the authorized official.
Authorized Official Title or Position: CFO
The title or position of the authorized official.
Authorized Official Telephone Number: 7026165507
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 207RR0500X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP