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1154242329 NPI number — CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS, INC

NPI Number: 1154242329
Health Care Provider/Practitioner: CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS, INC

Information about “1154242329” NPI (CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS, INC) exists in 1154242329 in HTML format HTML  |  1154242329 in plain Text format TXT  |  1154242329 in PDF (Portable Document Format) PDF  |  1154242329 in an XML format XML  formats.

NPI Number : 1154242329 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154242329",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS, INC.",
    "ParentOrgTIN": null,
    "OrgName": "CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 29650",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85038-9650",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1960 RIVERSIDE PKWY STE 107",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAWRENCEVILLE",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30043-5945",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "404-400-6817",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/23/2026",
    "LastUpdateDate": "07/23/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CAMPBELL",
    "AuthorizedOfficialFirstName": "NEVILLE",
    "AuthorizedOfficialMiddleName": "F",
    "AuthorizedOfficialTitle": "CEO/MEDICAL DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "702-476-9700",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207LP2900X",
        "TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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