PROCARE MEDICAL GROUP LLC (NPI# 1366618019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366618019 |
| Entity Type | Organization |
| Organization Name | PROCARE MEDICAL GROUP LLC |
| Practice Address |
6870 S Rainbow Blvd Suite 106 & 107 Las Vegas NV 89118-2106 |
| Practice Telephone | 7023966000 |
| Practice Fax Number | 7023966001 |
| Mailing Telephone | 7023966000 |
| Mailing Fax Number | 7023966001 |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2019-11-21 |
| Authorized Official Name | AMBER GANTZ (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 7023966000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 12502 | NV | Allopathic & Osteopathic Physicians |
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
12502 | NV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BT9475117 | 01 | |
| NV | LICENSE NUMBER | 12502 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407308752 | Procare Medical Group LLC | Family Medicine | 3000 Dundee Rd, Suite 311, Northbrook, IL 60062-2422 | 2016-11-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PROCARE MEDICAL GROUP LLC | 1976 Crotona Parkway, 4th Floor, Bronx, Ny 10460 |
| Street Address |
6870 S RAINBOW BLVD SUITE 106 & 107 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89118-2106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376767673 | Warren W Magnus | Family Medicine | 6870 S Rainbow Blvd, Ste 107, Las Vegas, NV 89118-2107 | 2007-04-11 |
| 1306406426 | Visioinworks, Inc | Eyewear Supplier (Equipment, not the service) | 6870 S Rainbow Blvd, Las Vegas, NV 89118-2106 | 2019-06-20 |
| 1962773135 | Procare Pharmacy LLC | Pharmacy | 6870 S Rainbow Blvd, Suite 106, Las Vegas, NV 89118-2106 | 2012-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720568520 | Kurt Yaross | Behavioral Analyst | 7138 W Post Rd, #208, Las Vegas, NV 89118 | 2018-08-21 |
| 1619457108 | Michelle Herzberg | Behavioral Analyst | 7318 W Post Rd #280, Las Vegas, NV 89118 | 2018-08-15 |
| 1548749385 | Keisha Bere-ruiz | Behavioral Analyst | 7318 W Post Rd #208, Las Vegas, NV 89118 | 2018-08-13 |
| 1295222081 | Aliantcare | Radiologic Technologist | 5490 S Rainbow Blvd, Suite 400 N34835, Las Vegas, NV 89118 | 2018-04-17 |
| 1710406467 | Anoush H. Tacvorian Do LLC | Clinic/Center | 6525 W. Warm Springs Rd, Suite 100, Las Vegas, NV 89118 | 2017-09-13 |
| 1962920470 | Harvard Medtech, LLC | Durable Medical Equipment & Medical Supplies | 6280 S. Valley View Blvd, Suite 412, Las Vegas, NV 89118 | 2017-09-05 |
| 1750827903 | Kerry Cutler | Nurse Practitioner | 6020 South Rainbow Blvd, Suite C, Las Vegas, NV 89118 | 2017-01-12 |
| 1184173015 | Girisgen & Kopolow Od PC | Optometrist | 7090 S Rainbow Blvd, Ste 100, Las Veegas, NV 89118 | 2016-10-04 |
| 1396117859 | Foundation for Positively Kids | Clinic/Center | 3555 E Reno, Ste F, Las Vegas, NV 89118 | 2015-10-23 |
| 1720492663 | Kiet Michael Lam | Chiropractor | 5693 S. Jones Bvld, Ste 116, Las Vegas, NV 89118 | 2014-06-18 |
| Find all providers in zip 89118 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013527845 | Carefirst Urgent Care, LLC | Clinic/Center | 5216 Boulder Hwy Ste 105, Las Vegas, NV 89122-6075 | 2020-08-06 |
| 1710549829 | University Medical Center of Southern Nevada | Clinic/Center | 4760 Blue Diamond Rd Ste 110, Las Vegas, NV 89139-7665 | 2019-06-28 |
| 1053879221 | Mclaughlin Medical Services Pllc | Clinic/Center | 1181 Grier Dr Ste C, Las Vegas, NV 89119-3746 | 2019-03-06 |
| 1013332378 | Patient Pal Urgent Care LLC | Clinic/Center | 11860 Southern Highlands Pkwy, #102, Las Vegas, NV 89141-3303 | 2014-02-24 |
| 1730431537 | Tropicana & Jones, LLC | Clinic/Center | 6105-6125 W Tropicana Avenue, Suite A,b,c, Las Vegas, AZ 89103 | 2012-10-04 |
| 1649522533 | Durango &cheyenne,llc | Clinic/Center | 8300 W Cheyenne, Suite 106, Las Vegas, NV 89129 | 2012-10-03 |
| 1346429388 | American Current Care Pa | Clinic/Center | 5850 South Polaris Road, Suite 100, Las Vegas, NV 89118-3185 | 2007-10-26 |
| 1720277593 | American Current Care, P.a. | Clinic/Center | 2200 S Rancho Dr, Suite 100, Las Vegas, NV 89102-4449 | 2007-10-17 |
| 1164629804 | Firstmed of Southern Nevada LLC | Clinic/Center | 3343 S Eastern Ave, Las Vegas, NV 89109-3312 | 2007-06-27 |
| 1982662912 | University Medical Center of Southern Nevada | Clinic/Center | 9320 W Sahara Ave, Las Vegas, NV 89117-5351 | 2006-05-01 |
| Find all providers in LAS VEGAS | ||||
Please comment or provide details below to improve the information on PROCARE MEDICAL GROUP LLC.
| 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.