FREMONT EMERGENCY SERVICES MANDAVIA LTD (NPI# 1679550149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679550149 |
| Entity Type | Organization |
| Organization Name | FREMONT EMERGENCY SERVICES MANDAVIA LTD |
| Other Organization Name | FREMONT EMERGENCY SERVICES (HENNER AND SEARS) LTD. |
| Practice Address |
9300 W Sunset Rd Las Vegas NV 89148-4844 |
| Mailing Address |
Po Box 638972 Cincinnati OH 45263-8972 |
| Practice Telephone | 7028802800 |
| Practice Fax Number | 7026716883 |
| Mailing Telephone | 9259241600 |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-01-10 |
| Authorized Official Name | SHARON HARDY (DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 9252516901 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 1679550149 | 05 |
| Other Name | Type Code |
|---|---|
| Fremont Emergency Services (Henner and Sears) Ltd. | Former Legal Business Name - Organization |
| Fremont Emergency Services (Mandavia), Ltd. | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316488141 | Fremont Emergency Services Mandavia Ltd | Physician Assistant | 7207 Aliante Parkway, North Las Vegas, NV 89128-0436 | 2017-03-13 |
| 1689013161 | Fremont Emergency Services Mandavia Ltd | Emergency Medicine | 3001 Saint Rose Pkwy, Henderson, NV 89052-3839 | 2013-06-18 |
| 1518120971 | Fremont Emergency Services Mandavia Ltd | Physician Assistant | 3186 S Maryland Pkwy, Las Vegas, NV 89109-2317 | 2008-07-07 |
| 1366429821 | Fremont Emergency Services Mandavia Ltd | Physician Assistant | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2005-12-27 |
| Street Address |
9300 W SUNSET RD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89148-4844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821627316 | Amol Patel | Student in an Organized Health Care Education/Training Program | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2020-04-06 |
| 1942839634 | Courtney R Nelson | Nurse Practitioner | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2020-04-04 |
| 1477180990 | David Blair Rosen | Student in an Organized Health Care Education/Training Program | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2020-03-25 |
| 1144857459 | Ian Weng Lam | Student in an Organized Health Care Education/Training Program | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2020-03-25 |
| 1669009221 | Kevin Byunghoon Oh | Student in an Organized Health Care Education/Training Program | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2020-03-24 |
| 1861029472 | Zeyu Xu | Student in an Organized Health Care Education/Training Program | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2020-03-24 |
| 1164088985 | Christina Seojung Schin | Student in an Organized Health Care Education/Training Program | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2019-05-16 |
| 1063078830 | Patrick Edward Janik | Student in an Organized Health Care Education/Training Program | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2019-05-16 |
| 1477012532 | Ranjay Kaushal | Student in an Organized Health Care Education/Training Program | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2019-03-18 |
| 1669931713 | Macklin Hong Phuoc Nguyen | Student in an Organized Health Care Education/Training Program | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2019-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293777 | Miguel Angel Umpierre | Technician | 9889 Overlook Ridge Ave, Las Vegas, NV 89148 | 2020-10-21 |
| 1689280588 | Santos Nunez | Technician | 7950 Mcginnis Ave, Las Vegas, NV 89148 | 2020-09-17 |
| 1861007734 | Daniel D Forro | Occupational Therapist | 10164 Phelps Lake Ct, Las Vegas, NV 89148 | 2020-09-08 |
| 1568098309 | Moinca R Ponce | Dentist | 9450 West Russell Rd, Suite #103, Las Vegas, NV 89148 | 2020-03-12 |
| 1689214876 | Mama Dukes Healthcare Services LLC | Rehabilitation Counselor | 9908 Masterpeice Drive, Las Vegas, NV 89148 | 2020-01-15 |
| 1720621865 | Building Hope Nevada | Community/Behavioral Health | 8936 Spanish Ridge, Las Vegas, NV 89148 | 2019-10-22 |
| 1790343721 | Maretes Godinez | Case Manager/Care Coordinator | 6070 S Fort Apache Rd., Suite 110, Las Vegas, NV 89148 | 2019-06-04 |
| 1295393601 | United Medical Group Pllc | Pharmacist | 9205 W. Russell Road, Building 3, Ste 240, Las Vegas, NV 89148 | 2019-05-31 |
| 1609358886 | Jdr Dermatology Research, LLC. | Dermatology | 9080 W Post Rd Ste 100, Las Vegas, NV 89148 | 2018-09-04 |
| 1902393929 | Hogue Healing Health and Hope, Pllc Dba H3, Pllc | Social Worker | 9205 W. Russell Rd Ste 240 Bldg 3, Las Vegas, NV 89148 | 2018-04-16 |
| Find all providers in zip 89148 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578180469 | Athlete Advantage Medical | Emergency Medicine | 6771 W Charleston Blvd Ste B, Las Vegas, NV 89146-9016 | 2020-06-26 |
| 1588219117 | Spring Valley Medical Center | Emergency Medicine | 9217 S Cimarron Rd, Las Vegas, NV 89178 | 2019-08-09 |
| 1245740133 | Insight Medical Associates LLC | Emergency Medicine | 500 N Rainbow Blvd Ste 300-230, Las Vegas, NV 89107-1082 | 2017-10-04 |
| 1912438763 | Dominic Diprinzio | Emergency Medicine | 901 Ranch Lane, Suite 135, Las Vegas, NV 89106 | 2017-03-23 |
| 1740643998 | Ryan Patrick Casarella | Emergency Medicine | 653 N Town Center Dr # 657, Las Vegas, NV 89144-0514 | 2016-04-04 |
| 1437548906 | Clinic 21 of Nevada Zyniewicz Pllc | Emergency Medicine | 5216 Boulder Hwy, Suite 105, Las Vegas, NV 89122-6074 | 2015-01-21 |
| 1114189917 | Stephanos Paraskevas Orphanidis | Emergency Medicine | 8670 W Cheyenne Ave Ste 120, Maimonides Medical Center Department of Emergency Med, Las Vegas, NV 89129-7457 | 2008-07-02 |
| 1104011527 | Joeann K Leong | Emergency Medicine | 8670 West Cheyenne Avenue, Suite 120, Las Vegas, NV 89129 | 2007-09-10 |
| 1376741256 | Jack Sui Ki Chan | Emergency Medicine | 1350 N Town Center Dr Unit 1033, Las Vegas, NV 89144-0577 | 2007-07-03 |
| 1700087392 | Jason Donovan Klein | Emergency Medicine | 9880 W Flamingo Rd, Las Vegas, NV 89147-8085 | 2007-05-30 |
| 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.