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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
10584 | NV | Allopathic & Osteopathic Physicians |
Street Address |
43 DRIFTING SHADOW WAY |
City | LAS VEGAS |
State | NV |
Zip Code | 89135 |
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 |
Find all providers in zip 89135 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
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. |
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 |
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.