OLYMPIC MEDICAL (NPI# 1174176143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174176143 |
| Entity Type | Organization |
| Organization Name | OLYMPIC MEDICAL |
| Practice Address |
2980 S Jones Blvd Ste C Las Vegas NV 89146-5657 |
| Mailing Address |
2505 Anthem Village Dr Ste E-101 Henderson NV 89052-5505 |
| Practice Telephone | 9529237256 |
| Practice Fax Number | 7024429793 |
| Mailing Telephone | 9529237256 |
| Mailing Fax Number | 7024429793 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |
| Authorized Official Name | ELIZABETH C BROWN (OWNER/APRN) |
| Authorized Official Telephone | 9529237256 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992073472 | Olympic Medical | Durable Medical Equipment & Medical Supplies | 5246 Olympic Dr Nw, Suite 117, Gig Harbor, WA 98335-1723 | 2011-12-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | OLYMPIC MEDICAL BILLING LLC | 36 Upper Falls Creek Rd, Elma, WA 98541 |
| System for Award Management (SAM) Entities | OLYMPIC MEDICAL CENTER | 939 Caroline St, Port Angeles, WA 98362-3909 |
| Washington State Corporations | OLYMPIC MEDICAL CENTER ASSOCIATES, LTD., A WASHINGTONLIMITED PARTNERSHIP | 1100 Pacific Bldg, Seattle, WA 98104 |
| Washington State Corporations | OLYMPIC MEDICAL CENTER FOUNDATION | 1015 Georgiana St, Port Angeles, WA 98362-3917 |
| Washington State Corporations | OLYMPIC MEDICAL CONSULTANTS P.S., INC. | 1411 Sw 296th St, Federal Way, WA 98023-3411 |
| Washington State Corporations | OLYMPIC MEDICAL CORP. | 5900 1st Ave S, Seattle, WA 98108 |
| Washington State Corporations | OLYMPIC MEDICAL GROUP INCORPORATED | 1945 4th Avenue East, Olympia, WA 98506 |
| Washington State Corporations | OLYMPIC MEDICAL LEGAL CONSULTANTS, INC. | 4528 49th Ave S, Seattle, WA 98118 |
| New York State Corporations | OLYMPIC MEDICAL SUPPLY GROUP CORP. | 1440 Broadway, 23rd Floor, New York, New York 10018 |
| Washington State Corporations | OLYMPIC MEDICAL SYSTEMS, INC. | 601 Union St # 4100 Po Box 21926, Seattle, WA 98111-3926 |
| Street Address |
2980 S JONES BLVD STE C |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89146-5657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336553171 | Desert Pulmonary Rehabilitation and Diagnostics LLC | Respiratory Therapist, Certified | 2980 S Jones Blvd Ste C, Las Vegas, NV 89146-5657 | 2014-06-19 |
| 1447650486 | Desert Pulmonary Rehabilitation and Diagnostics LLC | Respiratory Therapist, Registered | 2980 S Jones Blvd Ste C, Las Vegas, NV 89146-5657 | 2014-08-27 |
| 1750795449 | Kimberly Wilhelm | Respiratory Therapist, Registered | 2980 S Jones Blvd Ste C, Las Vegas, NV 89146-5657 | 2014-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821607193 | State of Nevada | Community/Behavioral Health | 6171 W Charleston Blvd Bldg 15, Las Vegas, NV 89146 | 2020-07-23 |
| 1730726597 | Jenna Leigh White | Occupational Therapist | 2012 S Jones Blvd., Las Vegas, NV 89146 | 2019-11-28 |
| 1649828898 | Rocio Ferat | Chore Provider | 5000 W. Oakey Suite E.i, Las Vegas, NV 89146 | 2019-08-30 |
| 1912554007 | Juan Zamora | Chore Provider | 5000 W. Oakey Bld Suite E-1, Las Vegas, NV 89146 | 2019-08-22 |
| 1407402530 | Elia Rocio Vargas-sifuentes | Chore Provider | 5000 W Oakey, Suite E.i, Las Vegas, NV 89146 | 2019-08-14 |
| 1740834050 | Zi Wang | Physician Assistant | 5300 Spring Mountain Rd Ste 112, Las Vegas, NV 89146 | 2019-07-25 |
| 1871145565 | Virginia Lopez Lopez | Chore Provider | 5000 W. Oakey Blvd. Suite E-1, Las Vegas, NV 89146 | 2019-07-12 |
| 1962054726 | Nona Sixta Q Baldonado | Technician | 5450 W Sahara Ave Ste 250a, Las Vegas, NV 89146 | 2019-07-11 |
| 1326600701 | Thelma Moreno Cerros | Chore Provider | 5000 W. Oakey Blvd Suite E-1, Las Vegas, NV 89146 | 2019-07-05 |
| 1992367866 | Carolina Perez | Chore Provider | 5000 W Oakey Blvd Suite E-1, Las Vegas, NV 89146 | 2019-07-01 |
| Find all providers in zip 89146 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404074 | Ibukun Odutola | Nurse Practitioner | 2605 E Flamingo Rd, Las Vegas, NV 89121-5241 | 2020-07-14 |
| 1225652191 | Angela Beth Wilson | Nurse Practitioner | 5440 W Sahara Ave Ste 220, Las Vegas, NV 89146-0355 | 2020-06-05 |
| 1104445394 | Universal Psychiatry LLC | Nurse Practitioner | 270 E Flamingo Rd Unit 122, Las Vegas, NV 89169-0325 | 2020-04-09 |
| 1952931271 | Paramount Healthcare Services Corp | Nurse Practitioner | 10141 Rockridge Peak Ave, Las Vegas, NV 89166-5200 | 2020-01-26 |
| 1730642182 | Aban Medical Services | Nurse Practitioner | 10145 Eagle Haven St, Las Vegas, NV 89141-8781 | 2019-04-11 |
| 1750857728 | Jan Michael Arceo | Nurse Practitioner | 3140 S Rainbow Blvd Ste 401, Las Vegas, NV 89146-6234 | 2018-10-17 |
| 1780110247 | Jon A Failla Aprn Pllc | Nurse Practitioner | 182 Apache Tear Ct, Las Vegas, NV 89123-2996 | 2017-05-03 |
| 1023565074 | Bright Star Nurse Care LLC | Nurse Practitioner | 8337 Fox Brook St, Las Vegas, NV 89139-6755 | 2016-09-07 |
| 1467805119 | Kasey James Dean | Nurse Practitioner | 3321 N Buffalo Dr, Suite 200, Las Vegas, NV 89129-6678 | 2016-07-18 |
| 1558757021 | Martin Binyange | Nurse Practitioner | 320 E Warm Springs Rd Unit 1, Las Vegas, NV 89119-4243 | 2015-04-12 |
| 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.