Healthcare Provider Details

I. General information

NPI: 1336452119
Provider Name (Legal Business Name): KIMBERLY A ADAMS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2010
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 S DURANGO DR
LAS VEGAS NV
89113-0137
US

IV. Provider business mailing address

10300 W CHARLESTON BLVD STE 13
LAS VEGAS NV
89135-5008
US

V. Phone/Fax

Practice location:
  • Phone: 719-941-1400
  • Fax: 702-253-0009
Mailing address:
  • Phone: 719-941-1400
  • Fax: 702-982-8542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY A ADAMS
Title or Position: PROVIDER
Credential:
Phone: 719-941-1400