DR. JONATHAN WYATT BOLD


Address: 43 Drifting Shadow Way, Las Vegas, NV 89135
Phone: 9525951301

DR. JONATHAN WYATT BOLD (NPI# 1053390021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053390021
Entity Type Individual
Full Name DR. JONATHAN WYATT BOLD
Credential M.D.
Practice Address 43 Drifting Shadow Way
Las Vegas
NV 89135
Mailing Address 11995 Singletree Ln
Suite 500
Eden Prairie
MN 55344-5347
Practice Telephone 9525951301
Practice Fax Number 6122944903
Mailing Telephone 9525951301
Mailing Fax Number 6122944903
Enumeration Date 2006-01-10
Last Update Date 2018-08-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
10584 NV Allopathic & Osteopathic Physicians

Office Location

Street Address 43 DRIFTING SHADOW WAY
City LAS VEGAS
State NV
Zip Code 89135

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1033743083 Summerlin Medical Durable Medical Equipment & Medical Supplies 10300 W. Charleston Blvd., Suite 13, Las Vegas, NV 89135 2020-02-28
1902363344 Arle Troy Ceniza Jumalon Physical Therapist 10401 West Charleston Blvd, Las Vegas, NV 89135 2019-02-21
1952887473 Randon Ralph Pharmacist 10250 W.charleston Blvd, Las Vegas, NV 89135 2018-07-17
1528463981 Century Vision Center, Chtd. Optometrist 10870 W. Charleston Blvd, Ste 105, Las Vegas, NV 89135 2014-10-28
1669808390 Nourollah Ghahreman Internal Medicine 3291 Mission Creek Court, Las Vegas, NV 89135 2013-09-26
1033485560 Jessica L Benesh Speech-Language Pathologist 11053 Crystal Crest Court, Las Vegas, NV 89135 2012-03-29
1053696237 Jaclyn Latteri Pharmacist 5442 Nettle Way, Las Vegas, NV 89135 2011-10-19
1235384033 Nancee Larson Registered Nurse 3418 Antique Rose Drive, Lasvegas, NV 89135 2008-11-20
1528250966 Manish P Gupta Internal Medicine 66 Hawkridge Drive, Las Vegas, NV 89135 2007-08-09
1205036134 Albertsons LLC Durable Medical Equipment & Medical Supplies 11720 W Charleston Blvd, Las Vegas, NV 89135 2007-07-19
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346860624 Smi Imaging LLC Radiology 7455 W Washington Ave Ste 120, Las Vegas, NV 89128-4338 2020-04-16
1548807274 Smi Imaging LLC Radiology 3560 W Flamingo Rd, Ste 100, Las Vegas, NV 89121-5088 2019-12-02
1316583297 Smi Imaging LLC Radiology 8530 W Sunset Rd Ste 120, Las Vegas, NV 89113-2244 2019-11-26
1114563095 Smi Imaging LLC Radiology 7540 Oso Blanca Rd Ste 140, Las Vegas, NV 89149-1417 2019-11-26
1396381273 Smi Imaging LLC Radiology 7610 W Cheyenne Ave Ste 100, Las Vegas, NV 89129-6761 2019-11-26
1740826627 Smi Imaging LLC Radiology 3061 S Maryland Pkwy Ste 102, Las Vegas, NV 89109-6226 2019-11-26
1366000622 6radiology Radiology 11266 Parleys Cone Ct, Las Vegas, NV 89135-1839 2019-06-03
1396271698 Cheryl Jayne Radiology 2225 Scarlet Rose Dr, Las Vegas, NV 89134-5905 2017-05-04
1174997407 Sutter Valley Medical Foundation Radiology 2995 American River Ln, Las Vegas, NV 89135-1713 2015-11-24
1467879205 Ross Leon Prujan Radiology 11663 Glowing Sunset Ln, Las Vegas, NV 89135-1659 2014-03-18
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Competitor

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City LAS VEGAS
Zip Code 89135

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Dataset Information

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.

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