GOOD SAMARITAN FAMILY PRACTICE (NPI# 1366802159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366802159 |
| Entity Type | Organization |
| Organization Name | GOOD SAMARITAN FAMILY PRACTICE |
| Practice Address |
4220 Saxton Green Avenue Las Vegas NV 89141 |
| Mailing Address |
4220 Saxton Green Ave Las Vegas NV 89141-4354 |
| Practice Telephone | 7024000517 |
| Mailing Telephone | 7024000517 |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |
| Authorized Official Name | STANLEY M KIDIAVAYI (NURSE PRACTICTIONER) |
| Authorized Official Telephone | 7024000517 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN002072 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4220 SAXTON GREEN AVENUE |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395869 | Brighter Development Behavorial Health Services | Community Based Residential Treatment Facility, Mental Illness | 3228 Villa Fiori Avenue, Las Vegas, NV 89141 | 2020-10-29 |
| 1356979041 | Maria Magdalena Gonzalez | Technician | 10801 Brumana Ct., Las Vegas, NV 89141 | 2020-03-30 |
| 1730714569 | Gulati Highlands Dentistry, PC | Dentist | 4380 W. Cactus Ave, Suite 100, Las Vegas, NV 89141 | 2020-03-12 |
| 1275172173 | Joan Lou Paras Nakar | Nurse Practitioner | 9793 Dakota Creek Ct, Las Vegas, NV 89141 | 2019-12-26 |
| 1376008193 | Life Dentistry - Dr Duff, Pllc | Clinic/Center | 10670 Dean Martin Dr., Suite 100, Las Vegas, NV 89141 | 2019-02-06 |
| 1376030056 | Anne Florence Valdez | Optometrist | 5407 Ledgewood Creek Ave, Las Vegas, NV 89141 | 2018-04-18 |
| 1700301900 | Erica Michelle Capehart | Student in an Organized Health Care Education/Training Program | 5564 Valensole Avenue, Las Vegas, NV 89141 | 2017-08-08 |
| 1912429044 | Candace A Harris | Community Health Worker | 108186 Valencia Hills Street, Las Vegas, NV 89141 | 2017-07-11 |
| 1588007405 | Vanessa Cazares | Rehabilitation Practitioner | 3500 Arcarta Point, Las Vegas, NV 89141 | 2013-04-10 |
| 1326396987 | Joe Hardenbrook | Counselor | 7729 Maverick, Las Vegas, NV 89141 | 2012-08-29 |
| Find all providers in zip 89141 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396651 | Alma F Talavera | Nurse Practitioner | 5982 Juniper Falls Ave, Las Vegas, NV 89130-2827 | 2020-11-06 |
| 1154922300 | Reynaly Campos | Nurse Practitioner | 10680 Spruce Bough St, Las Vegas, NV 89183-4631 | 2020-11-04 |
| 1811596463 | Carolina Salaberrios | Nurse Practitioner | 8440 W Lake Mead Blvd Ste 111, Las Vegas, NV 89128-7648 | 2020-10-23 |
| 1851990840 | John Marius Agravio Tolentino | Nurse Practitioner | 3557 Winter Wren St, Las Vegas, NV 89122-3539 | 2020-10-21 |
| 1811596760 | Emmelyn Pineda Rivas | Nurse Practitioner | 7852 Lovely Pine Pl, Las Vegas, NV 89143-4431 | 2020-10-21 |
| 1659979052 | Francis Torres | Nurse Practitioner | 10010 Fort Pike St, Las Vegas, NV 89178-7543 | 2020-10-16 |
| 1144828849 | Julio Arvie Mata Madarazo Jr. | Nurse Practitioner | 6284 Canvasback Ave, Las Vegas, NV 89122-3545 | 2020-10-14 |
| 1104424076 | Khelsey Macaspac | Nurse Practitioner | 6446 Dunns River St, Las Vegas, NV 89166-8064 | 2020-10-13 |
| 1912505199 | Angelica Villahermosa | Nurse Practitioner | 8115 Dancing Bull Ct, Las Vegas, NV 89139-6702 | 2020-10-11 |
| 1467050625 | Ruby Borja | Nurse Practitioner | 7329 Perkins Hill St, Las Vegas, NV 89166-6505 | 2020-10-10 |
| 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.