SAINT JUDE MEDICAL GROUP LLC HOME DOCTORS (NPI# 1730713611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730713611 |
| Entity Type | Organization |
| Organization Name | SAINT JUDE MEDICAL GROUP LLC HOME DOCTORS |
| Other Organization Name | HOME DOCTORS |
| Practice Address |
4412 W Charleston Blvd Ste B Las Vegas NV 89102-1636 |
| Practice Telephone | 7029346441 |
| Mailing Telephone | 7029346441 |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | NERISSA DIMAILIG (MANGING MEMBER) |
| Authorized Official Telephone | 7029346441 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| HOME DOCTORS | Doing Business As Name - Organization |
| Street Address |
4412 W CHARLESTON BLVD STE B |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89102-1636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998397 | Natasha Moore | Technician | 3210 W Charleston Suite 2, Las Vegas, NV 89102 | 2020-10-07 |
| 1568077113 | Zulma Yaneth Tervizo Lopez | Technician | 455 W Oakey Blvd, Ste 111, Las Vegas, NV 89102 | 2020-09-10 |
| 1922629765 | Bianca Vaudreuil | Religious Nonmedical Practitioner | 3210 W Charleston Ste 2, Las Vegas, NV 89102 | 2020-05-04 |
| 1720608052 | Angelica Gutierrez | Technician | Vegas Compassionate Care ; 2820 W. Charleston Blvd B-21, Las Vegas, NV 89102 | 2020-04-16 |
| 1396370680 | Juana Maria Hernandez | Technician | 2881 S. Valley View Blvd, Suite #6, Las Vegas, NV 89102 | 2020-03-06 |
| 1609409648 | Janie Washington | Technician | 3210 W Charleston Blvd. Suite 2, Las Vegas, NV 89102 | 2020-02-18 |
| 1447893185 | Maria Josefina Castaneda | Technician | 2881 S. Valley View Blvd Suite #6, Los Vegas, NV 89102 | 2019-10-25 |
| 1427608777 | Virginia Hernandez Tolentino | Technician | 4550 W Oakley Blvd, Suite 101 A, Las Vegas, NV 89102 | 2019-09-18 |
| 1972153872 | Gladiola Cardoza Quinones | Technician | 2881 S. Valley View Blvd #6, Las Vegas, NV 89102 | 2019-09-13 |
| 1801445572 | Rafael Roberto Gonzalez Palomino | Homemaker | 4550 W. Oakey Blvd, Suite 111-0, Las Vegas, NV 89102 | 2019-09-05 |
| Find all providers in zip 89102 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831709740 | Marizel Yukee | Nurse Practitioner | 3086 Lapis Beach Dr, Las Vegas, NV 89117 | 2020-08-05 |
| 1821619867 | Instadoctor LLC | Nurse Practitioner | 6280 S Valley View Blvd Ste 736, Las Vegas, NV 89118-6833 | 2020-04-30 |
| 1780205823 | Diao Np Pllc | Nurse Practitioner | 8972 Frasure Falls Ave, Las Vegas, NV 89178-7215 | 2020-04-29 |
| 1184274037 | Jocybel Itorralba | Nurse Practitioner | 2440 Professional Ct Ste 110, Las Vegas, NV 89128-0839 | 2019-09-12 |
| 1679121958 | Priority Health System LLC | Nurse Practitioner | 2655 S Rainbow Blvd Ste 410, Las Vegas, NV 89146-5100 | 2019-08-29 |
| 1386205052 | Rhia Joy Lumanog Dizon | Nurse Practitioner | 7003 Tidelands Park Ct, Las Vegas, NV 89166-7132 | 2019-06-24 |
| 1184284283 | Brianemmanuel Amat Del Rosario | Nurse Practitioner | 7350 W Centennial Pkwy Unit 2008, Las Vegas, NV 89131-1646 | 2019-06-19 |
| 1467912386 | Shannon Lee Latham | Nurse Practitioner | 801 S Rancho Dr Ste F1, Las Vegas, NV 89106-3814 | 2019-03-25 |
| 1013484096 | Riza Barraquias Leong | Nurse Practitioner | 5537 Silent Springs Dr, Las Vegas, NV 89122-8661 | 2018-10-29 |
| 1962984823 | Candace Lawhorn-williams | Nurse Practitioner | 10848 Wallflower Ave, Las Vegas, NV 89135-2862 | 2018-09-06 |
| 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.