DR. KEVIN RAY BUCKWALTER (NPI# 1003813478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003813478 |
Entity Type | Individual |
Full Name | DR. KEVIN RAY BUCKWALTER |
Credential | MD |
Practice Address |
7151 Cascade Valley Ct Ste 200 Las Vegas NV 89128-0498 |
Mailing Address |
1280 Monument Blvd # 1 Concord CA 94520-4405 |
Practice Telephone | 7025688450 |
Practice Fax Number | 7025688451 |
Mailing Telephone | 9167336993 |
Mailing Fax Number | 9167336989 |
Enumeration Date | 2005-06-30 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | A63401 | CA | Allopathic & Osteopathic Physicians |
N | 208600000X | Surgery | A63401 | CA | Allopathic & Osteopathic Physicians |
Y | 208D00000X | General Practice | 8476 | NV | Allopathic & Osteopathic Physicians |
N | 208D00000X | General Practice | A63401 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NV | LICENSE | 8476 | 01 |
CA | LICENSE | A63401 | 01 |
CA | MCARE PTAN | 00A634010 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
1280 Monument Blvd, # 1, Concord, CA 945204405 | 9167336993 | 9167336989 |
Street Address |
7151 CASCADE VALLEY CT STE 200 |
City | LAS VEGAS |
State | NV |
Zip Code | 89128-0498 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619452968 | Mountain View Pain Management | General Practice | 7151 Cascade Valley Ct Ste 200, Las Vegas, NV 89128-0498 | 2018-10-02 |
1336503713 | Tao Bon Jr. | Physical Therapist | 7151 Cascade Valley Ct Ste 200, Las Vegas, NV 89128-0498 | 2016-04-11 |
1386739696 | Graham Michael Wilson | General Practice | 7151 Cascade Valley Ct Ste 200, Las Vegas, NV 89128-0498 | 2006-10-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699374256 | Dmc Medical Clinic Ltd | Family Medicine | 7140 Smoke Ranch Road, 150, Las Vegas, NV 89128 | 2020-10-23 |
1619589462 | Eldercare Services Lv, LLC | Technician | 8430 W. Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-08-21 |
1508477308 | Amneris Lizet Duran-brocato | Technician | 1150 North Buffalo Dr. Apt 2120, Las Vegas, NV 89128 | 2020-08-14 |
1366082612 | Ar Home Health Management LLC | Home Health | 7465 W Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-01-14 |
1114563731 | Leslie A Pasternack | Acupuncturist | Integrated Acupuncture of Southern Nevada, 7250 Peak Dr #106, Las Vegas, NV 89128 | 2019-11-19 |
1154977940 | Devora Susana Leon-lopez | Chore Provider | 7320 Smoke Ranch Rd. Ste. H, Las Vegas, NV 89128 | 2019-08-16 |
1659924884 | Blanca Estela Garnica-mendez | Chore Provider | 7320 Smoke Ranch Rd. Suite H, Suite H, Las Vegas, NV 89128 | 2019-07-17 |
1467913160 | Sherwin Necunazar Azad | Student in an Organized Health Care Education/Training Program | Mountainview Hospital Gme, 3100 N. Tenaya Way, Las Vegas, NV 89128 | 2019-03-26 |
1962963801 | Michael Richard Korczynski | Student in an Organized Health Care Education/Training Program | 3100 North Tenaya Way, Las Vegas, NV 89128 | 2019-03-25 |
1013477041 | Yuanlong Zhao | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way Graduate Medical Education, Las Vegas, NV 89128 | 2019-03-25 |
Find all providers in zip 89128 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780281451 | Korn Health Solutions, Pllc | General Practice | 8530 W Sunset Rd Ste 305, Las Vegas, NV 89113-2215 | 2020-10-06 |
1740898253 | Cano Health Nevada Pllc | General Practice | 3265 E Tropicana Ave, Las Vegas, NV 89121-7386 | 2020-07-21 |
1225530553 | Real Time Physicians, LLC | General Practice | 3855 W Diablo Dr Ste 2, Las Vegas, NV 89118-2343 | 2018-03-02 |
1063847317 | Mh Health Care Services, PC | General Practice | 7135 W Sahara Ave Ste 100, C/o Laborers Health Center, Las Vegas, NV 89117-2828 | 2013-09-05 |
1386078582 | Richard F Russell | General Practice | 2221 S Tioga Way, Las Vegas, NV 89117-2735 | 2013-08-25 |
1790125862 | Ihawa | General Practice | 1504 Couples St, Las Vegas, NV 89128-2155 | 2013-07-03 |
1154768620 | Francisco Martinez Villanueva | General Practice | 8652 Grandbank Dr, Las Vegas, NV 89145-4813 | 2013-05-23 |
1588900716 | Dean Grant Peterson | General Practice | 3021 Waterside Cir, Las Vegas, NV 89117-2277 | 2012-12-15 |
1205182292 | Integrated Medical Group Inc | General Practice | 3230 S Buffalo Dr Ste 105, Las Vegas, NV 89117-2506 | 2012-07-27 |
1083970248 | Sebastian Balle | General Practice | 6670 Palmyra Ave, Las Vegas, NV 89146-6539 | 2012-04-02 |
Find all providers in LAS VEGAS |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.