TRICIA AGUSTIN (NPI# 1063691673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063691673 |
| Entity Type | Individual |
| Full Name | TRICIA AGUSTIN |
| Credential | MD |
| Practice Address |
100 N Green Valley Pkwy Ste 239 Henderson NV 89074-7704 |
| Mailing Address |
2370 Corporate Cir Ste 300 Henderson NV 89074-7760 |
| Practice Telephone | 7028444841 |
| Practice Fax Number | 7028444844 |
| Mailing Telephone | 7029103950 |
| Mailing Fax Number | 7027782264 |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2019-02-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 13714 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 1063691673 | 05 |
| Street Address |
100 N GREEN VALLEY PKWY STE 239 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89074-7704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033182522 | Linda Lou Johnson | Internal Medicine | 100 N Green Valley Pkwy Ste 239, Henderson, NV 89074 | 2006-02-07 |
| 1134628480 | Bacchus Wakefield Kahan PC | Internal Medicine | 100 N Green Valley Pkwy Ste 239, Henderson, NV 89074-7704 | 2018-02-01 |
| 1801309919 | Heather Elisabeth Harvey | Nurse Practitioner | 100 N Green Valley Pkwy Ste 239, Henderson, NV 89074-7704 | 2017-11-10 |
| 1326574328 | Kelly Rowe | Nurse Practitioner | 100 N Green Valley Pkwy Ste 239, Henderson, NV 89074-7704 | 2017-05-11 |
| 1528444544 | Julian Kate Tuttle | Nurse Practitioner | 100 N Green Valley Pkwy Ste 239, Henderson, NV 89074-7704 | 2015-07-31 |
| 1992042758 | Lindsey L. Reynolds | Physician Assistant | 100 N Green Valley Pkwy Ste 239, Henderson, NV 89074 | 2013-01-12 |
| 1376591263 | David R Kahan | Internal Medicine | 100 N Green Valley Pkwy Ste 239, Henderson, NV 89074-7704 | 2006-05-04 |
| 1407814718 | Wendell G Burris | Family Medicine | 100 N Green Valley Pkwy Ste 239, Henderson, NV 89074-7704 | 2006-05-03 |
| 1831156041 | Liza J Bryant | Physician Assistant | 100 N Green Valley Pkwy Ste 239, Henderson, NV 89074 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349381 | Samuel Taylor Mulford | Physical Therapist | 9070 W.cheyenne Ave, Suite 100, Henderson, NV 89074 | 2020-06-03 |
| 1407369127 | Brenda Thomas | Dental Hygienist | 234 Polar Morning Place, Henderson, NV 89074 | 2017-11-16 |
| 1174036479 | Gail E Evans Wade | Behavioral Analyst | 1445 Stone Lake Cove, Henderson, NV 89074 | 2017-11-08 |
| 1710400957 | Kimberley Houk | Behavioral Analyst | 20 Avenida Picasso, Henderson, NV 89074 | 2017-07-19 |
| 1760911846 | Colin Ono-moore | Physical Therapist | 3 Rising Sun Ct, Henderson, NV 89074 | 2017-06-12 |
| 1851825764 | Ralph Wieder | Dietitian, Registered | 1005 Wigwam Pkwy, 23206, Henderson, NV 89074 | 2017-04-18 |
| 1811421712 | Henderson Long Term Care LLC | Skilled Nursing Facility | 2965 Wigwam Parkway, Henderson, NV 89074 | 2017-04-18 |
| 1275994642 | Malyna Lavarias | Behavioral Analyst | 74 N Pecos Rd., Suite C, Henderson, NV 89074 | 2016-03-14 |
| 1144608290 | Matthew Roderick | Acupuncturist | 2675 Windmill Pkwy Apt 421, Henderson, NV 89074 | 2015-05-08 |
| 1922494764 | Jennifer Romo Santistevan | Pediatrics | 1505 Wigwam Pkwy Ste 230, Henderson, NV 89074 | 2015-04-08 |
| Find all providers in zip 89074 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740807619 | Sherrin Soliman | Family Medicine | 761 Crest Valley Pl, Henderson, NV 89011-2663 | 2020-06-26 |
| 1932724143 | Qv Now Pllc | Family Medicine | 1600 Us Highway 79 S Ste B, Henderson, TX 75654-4508 | 2020-06-12 |
| 1154944544 | Partners In Primary Care Nv PC | Family Medicine | 390 W Lake Mead Pkwy, Henderson, NV 89015-7417 | 2020-05-20 |
| 1689134116 | Transforming Arts Inc | Family Medicine | 2900 N Green Valley Pkwy Ste 114, Henderson, NV 89014-0408 | 2019-03-21 |
| 1609359165 | Kenisha Voncille Thomas | Family Medicine | 1520 W Sunset Rd Ste 130, Henderson, NV 89014 | 2018-09-11 |
| 1336636521 | Bob Dillon Enterprises Ltd | Family Medicine | 90 S Stephanie St Ste 110, Henderson, NV 89012-5574 | 2018-04-13 |
| 1013425255 | Bikramjit Singh Nanar | Family Medicine | 1382 Opal Valley St, Henderson, NV 89052-3146 | 2018-01-22 |
| 1265965263 | La Boss LLC | Family Medicine | 2404 Chateau Napoleon Dr, Henderson, NV 89044-0377 | 2017-04-06 |
| 1679922959 | Sonia Garcia-jayne | Family Medicine | 2645 W Horizon Ridge Pkwy Ste 120, Henderson, NV 89052 | 2016-06-08 |
| 1043668015 | Michelle I-hung Lin | Family Medicine | 2865 Siena Heights Dr Ste 140, Henderson, NV 89052-4168 | 2016-05-31 |
| Find all providers in HENDERSON | ||||
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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.