NPI Code Detail JSON Logo

1942829346 NPI number — ELITE MD

NPI Number: 1942829346
Health Care Provider/Practitioner: ELITE MD

Information about “1942829346” NPI (ELITE MD) exists in 1942829346 in HTML format HTML  |  1942829346 in plain Text format TXT  |  1942829346 in PDF (Portable Document Format) PDF  |  1942829346 in an XML format XML  formats.

NPI Number : 1942829346 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1942829346",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ELITE MD",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2855 S BRONCO ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAS VEGAS",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89146-5207",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "702-329-9002",
    "MailingAddressFaxNumber": "702-745-2182",
    "FirstLinePracticeLocationAddress": "2855 S BRONCO ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAS VEGAS",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89146-5207",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "702-730-0926",
    "PracticeLocationAddressFaxNumber": "702-926-9658",
    "EnumerationDate": "04/15/2020",
    "LastUpdateDate": "01/27/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JUMAO-AS",
    "AuthorizedOfficialFirstName": "ELSIE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "702-793-5280",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM1300X",
          "TaxonomyName": "Multi-Specialty Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QP2300X",
          "TaxonomyName": "Primary Care Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.