1417080839 NPI number — UNIVERSITY OF NV SCHOOL OF MEDICINE MULTI SPECIALTY GROUP PRACTICE SO

NPI Number: 1417080839
Health Care Provider/Practitioner: UNIVERSITY OF NV SCHOOL OF MEDICINE MULTI SPECIALTY GROUP PRACTICE SO

NPI Number : 1417080839 – XML Data Format

                    
<?xml version="1.0" encoding="UTF-8"?>
<Npi>
	<NPI>
		1417080839
	</NPI>
	<EntityType>
		Organization
	</EntityType>
	<ReplacementNPI/>
	<EIN/>
	<IsSoleProprietor/>
	<IsOrgSubpart>
		N
	</IsOrgSubpart>
	<ParentOrgLBN/>
	<ParentOrgTIN/>
	<OrgName>
		UNIVERSITY OF NV SCHOOL OF MEDICINE MULTI SPECIALTY GROUP PRACTICE SO
	</OrgName>
	<LastName/>
	<FirstName/>
	<MiddleName/>
	<NamePrefix/>
	<NameSuffix/>
	<Credential/>
	<OtherOrgName/>
	<OtherOrgNameTypeCode>
		6
	</OtherOrgNameTypeCode>
	<OtherLastName/>
	<OtherFirstName/>
	<OtherMiddleName/>
	<OtherNamePrefix/>
	<OtherNameSuffix/>
	<OtherCredential/>
	<OtherLastNameTypeCode/>
	<FirstLineMailingAddress>
		PO BOX 29506
	</FirstLineMailingAddress>
	<SecondLineMailingAddress/>
	<MailingAddressCityName>
		LAS VEGAS
	</MailingAddressCityName>
	<MailingAddressStateName>
		NV
	</MailingAddressStateName>
	<MailingAddressPostalCode>
		89126-9506
	</MailingAddressPostalCode>
	<MailingAddressCountryCode>
		US
	</MailingAddressCountryCode>
	<MailingAddressTelephoneNumber>
		702-968-4371
	</MailingAddressTelephoneNumber>
	<MailingAddressFaxNumber>
		702-671-5170
	</MailingAddressFaxNumber>
	<FirstLinePracticeLocationAddress>
		1707 W CHARLESTON BLVD
	</FirstLinePracticeLocationAddress>
	<SecondLinePracticeLocationAddress>
		110B
	</SecondLinePracticeLocationAddress>
	<PracticeLocationAddressCityName>
		LAS VEGAS
	</PracticeLocationAddressCityName>
	<PracticeLocationAddressStateName>
		NV
	</PracticeLocationAddressStateName>
	<PracticeLocationAddressPostalCode>
		89102-2351
	</PracticeLocationAddressPostalCode>
	<PracticeLocationAddressCountryCode>
		US
	</PracticeLocationAddressCountryCode>
	<PracticeLocationAddressTelephoneNumber>
		702-968-4363
	</PracticeLocationAddressTelephoneNumber>
	<PracticeLocationAddressFaxNumber>
		702-671-0193
	</PracticeLocationAddressFaxNumber>
	<EnumerationDate>
		03/14/2007
	</EnumerationDate>
	<LastUpdateDate>
		10/14/2015
	</LastUpdateDate>
	<NPIDeactivationReasonCode/>
	<NPIDeactivationReason/>
	<NPIDeactivationDate/>
	<NPIReactivationDate/>
	<GenderCode/>
	<Gender/>
	<AuthorizedOfficialLastName>
		PALMER
	</AuthorizedOfficialLastName>
	<AuthorizedOfficialFirstName>
		ELISSA
	</AuthorizedOfficialFirstName>
	<AuthorizedOfficialMiddleName>
		J
	</AuthorizedOfficialMiddleName>
	<AuthorizedOfficialTitle>
		PRESIDENT
	</AuthorizedOfficialTitle>
	<AuthorizedOfficialNamePrefix>
		DR.
	</AuthorizedOfficialNamePrefix>
	<AuthorizedOfficialNameSuffix/>
	<AuthorizedOfficialCredential>
		MD
	</AuthorizedOfficialCredential>
	<AuthorizedOfficialTelephoneNumber>
		702-992-6888
	</AuthorizedOfficialTelephoneNumber>
	<Taxonomies>
		<Taxonomy>
			<TaxonomyCode>
				207SG0202X
			</TaxonomyCode>
			<TaxonomyName>
				Clinical Biochemical Genetics Physician
			</TaxonomyName>
			<LicenseNumber/>
			<LicenseNumberStateCode/>
			<PrimaryTaxonomySwitch>
				N
			</PrimaryTaxonomySwitch>
		</Taxonomy>
		<Taxonomy>
			<TaxonomyCode>
				207SG0203X
			</TaxonomyCode>
			<TaxonomyName>
				Clinical Molecular Genetics Physician
			</TaxonomyName>
			<LicenseNumber/>
			<LicenseNumberStateCode/>
			<PrimaryTaxonomySwitch>
				N
			</PrimaryTaxonomySwitch>
		</Taxonomy>
		<Taxonomy>
			<TaxonomyCode>
				207SG0205X
			</TaxonomyCode>
			<TaxonomyName>
				Ph.D. Medical Genetics Physician
			</TaxonomyName>
			<LicenseNumber/>
			<LicenseNumberStateCode/>
			<PrimaryTaxonomySwitch>
				N
			</PrimaryTaxonomySwitch>
		</Taxonomy>
		<Taxonomy>
			<TaxonomyCode>
				207SM0001X
			</TaxonomyCode>
			<TaxonomyName>
				Molecular Genetic Pathology (Medical Genetics) Physician
			</TaxonomyName>
			<LicenseNumber/>
			<LicenseNumberStateCode/>
			<PrimaryTaxonomySwitch>
				N
			</PrimaryTaxonomySwitch>
		</Taxonomy>
		<Taxonomy>
			<TaxonomyCode>
				291U00000X
			</TaxonomyCode>
			<TaxonomyName>
				Clinical Medical Laboratory
			</TaxonomyName>
			<LicenseNumber/>
			<LicenseNumberStateCode/>
			<PrimaryTaxonomySwitch>
				N
			</PrimaryTaxonomySwitch>
		</Taxonomy>
		<Taxonomy>
			<TaxonomyCode>
				207SC0300X
			</TaxonomyCode>
			<TaxonomyName>
				Clinical Cytogenetics Physician
			</TaxonomyName>
			<LicenseNumber/>
			<LicenseNumberStateCode/>
			<PrimaryTaxonomySwitch>
				Y
			</PrimaryTaxonomySwitch>
		</Taxonomy>
	</Taxonomies>
	<HealthcareProviderTaxonomyGroups>
		<HealthcareProviderTaxonomyGroup>
			<HealthcareProviderTaxonomyGroupName>
				193200000X MULTI-SPECIALTY GROUP
			</HealthcareProviderTaxonomyGroupName>
			<HealthcareProviderTaxonomyGroupDescription>
				Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization.
			</HealthcareProviderTaxonomyGroupDescription>
		</HealthcareProviderTaxonomyGroup>
		<HealthcareProviderTaxonomyGroup>
			<HealthcareProviderTaxonomyGroupName>
				193200000X MULTI-SPECIALTY GROUP
			</HealthcareProviderTaxonomyGroupName>
			<HealthcareProviderTaxonomyGroupDescription>
				Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization.
			</HealthcareProviderTaxonomyGroupDescription>
		</HealthcareProviderTaxonomyGroup>
		<HealthcareProviderTaxonomyGroup>
			<HealthcareProviderTaxonomyGroupName>
				193200000X MULTI-SPECIALTY GROUP
			</HealthcareProviderTaxonomyGroupName>
			<HealthcareProviderTaxonomyGroupDescription>
				Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization.
			</HealthcareProviderTaxonomyGroupDescription>
		</HealthcareProviderTaxonomyGroup>
		<HealthcareProviderTaxonomyGroup>
			<HealthcareProviderTaxonomyGroupName>
				193200000X MULTI-SPECIALTY GROUP
			</HealthcareProviderTaxonomyGroupName>
			<HealthcareProviderTaxonomyGroupDescription>
				Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization.
			</HealthcareProviderTaxonomyGroupDescription>
		</HealthcareProviderTaxonomyGroup>
		<HealthcareProviderTaxonomyGroup>
			<HealthcareProviderTaxonomyGroupName>
				193200000X MULTI-SPECIALTY GROUP
			</HealthcareProviderTaxonomyGroupName>
			<HealthcareProviderTaxonomyGroupDescription>
				Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization.
			</HealthcareProviderTaxonomyGroupDescription>
		</HealthcareProviderTaxonomyGroup>
	</HealthcareProviderTaxonomyGroups>
</Npi>

                    
                

NPI Number XSD (XML Schema Definition)

                
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                           <xs:element name="AuthorizedOfficialNamePrefix"></xs:element>
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                           <xs:element name="AuthorizedOfficialCredential"></xs:element>
                           <xs:element name="AuthorizedOfficialTelephoneNumber"></xs:element>
                           <xs:element name="Taxonomies">
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                                                               <xs:element name="PrimaryTaxonomySwitch" type="xs:string"></xs:element>
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