DIVINA GRACIA AVERILLA (NPI# 1467504175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467504175 |
| Entity Type | Individual |
| Full Name | DIVINA GRACIA AVERILLA |
| Other Name | DIVINA GRACIA AVERILLA-OBENA |
| Credential | MD |
| Practice Address |
3131 La Canada St Ste 200 Las Vegas NV 89169-2579 |
| Mailing Address |
Po Box 98978 Las Vegas NV 89193-8978 |
| Practice Telephone | 7023695582 |
| Practice Fax Number | 7026505148 |
| Mailing Telephone | 7022163346 |
| Mailing Fax Number | 7026716883 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2019-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 7308 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 1467504175 | 05 | |
| NV | 1202877 | 05 | |
| NV | STATE LICENSE | 7308 | 01 |
| Street Address |
3131 LA CANADA ST STE 200 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89169-2579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710966288 | Genadi Maltinski | Family Medicine | 3131 La Canada St Ste 200, Las Vegas, NV 89169-2579 | 2006-01-12 |
| 1013186964 | Chad Robinson Black | Family Medicine | 3131 La Canada St Ste 200, Las Vegas, NV 89169-2579 | 2008-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164038196 | Tammy E Smith | Home Health | 1500 Karen Ave, 65, Las Vegas, NV 89169 | 2020-09-16 |
| 1457978561 | Damon Lavell Cohran | Counselor | 459 Sierra Vista Dr, 32, Las Vegas, NV 89169 | 2020-07-06 |
| 1912543307 | Josephine R Hernandez | Rehabilitation Practitioner | Firstmed Health and Wellness Center Inc., 3343 S. Eastern Avenue, Las Vegas, NV 89169 | 2019-11-21 |
| 1528602174 | Cindy Pena Jaramillo | Technician | 3376 S. Eaatern Ave, Las Vegas, NV 89169 | 2019-11-06 |
| 1497309967 | Richard Snarr Worthen | Technician | 3175 South Eastern Ave, Las Vegas, NV 89169 | 2019-08-01 |
| 1447718796 | Hope Industries LLC | Chore Provider | 1711 E Desert Inn Rd, Las Vegas, NV 89169 | 2019-03-06 |
| 1609345321 | Diaz Health LLC | Community/Behavioral Health | 5225 West 2nd Street, Las Vegas, NV 89169 | 2018-11-26 |
| 1902371024 | Kevin Burnett | Technician | 1100 Dunmont Apt 202, Las Vegas, NV 89169 | 2018-10-04 |
| 1659865111 | Kimberly Jackson-hampton | Counselor | 335 E Harmon Ave Apt 30, Las Vegas, NV 89169 | 2018-06-19 |
| 1093216350 | Blessed Services LLC | Community/Behavioral Health | 2525 White Street, Las Vegas, NV 89169 | 2018-02-22 |
| Find all providers in zip 89169 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374256 | Dmc Medical Clinic Ltd | Family Medicine | 7140 Smoke Ranch Road, 150, Las Vegas, NV 89128 | 2020-10-23 |
| 1558968420 | Neuro Health LLC | Family Medicine | 7455 W Washington Ave Ste 140, Las Vegas, NV 89128-4349 | 2020-10-05 |
| 1154934131 | Body & Mind Uplifment LLC | Family Medicine | 2215 Renaissance Dr Ste A, Las Vegas, NV 89119-6723 | 2020-08-28 |
| 1639788599 | Telelab | Family Medicine | 7881 W Charleston Blvd Ste 230, Las Vegas, NV 89117-8327 | 2020-07-27 |
| 1629687926 | Maria Habbi Md | Family Medicine | 501 S Rancho Dr Ste F40, Las Vegas, NV 89106-4834 | 2020-07-23 |
| 1225646805 | Shelley Elizabeth Ameduri | Family Medicine | 3943 Deluge Dr, Las Vegas, NV 89129-6481 | 2020-07-20 |
| 1659995090 | Universal Medical Alliance Inc. | Family Medicine | 6268 Spring Mountain Rd Ste 115b, Las Vegas, NV 89146-8873 | 2020-06-02 |
| 1255954640 | Partners In Primary Care Nv PC | Family Medicine | 4919 W Craig Rd, Las Vegas, NV 89130-2730 | 2020-05-20 |
| 1669095048 | Partners In Primary Care Nv PC | Family Medicine | 4813 S Eastern Ave, Las Vegas, NV 89119-6188 | 2020-05-20 |
| 1184247579 | Partners In Primary Care Nv PC | Family Medicine | 3129 N Rainbow Blvd, Las Vegas, NV 89108-4578 | 2020-05-20 |
| Find all providers in LAS VEGAS | ||||
Please comment or provide details below to improve the information on DIVINA GRACIA AVERILLA.
| 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.