MEDICARE: INSPIRADA PEDIATRICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1144923459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRADA PEDIATRICS LLC

Provider Business Mailing Address
First Line	:	475 E BRUNER AVE
Second Line	:	STE 130
City	:	HENDERSON
State	:	NV
Zip	:	89044-0237
Country	:	US
Telephone Number	:	702-763-2263
Fax Number	:	702-723-3765

Provider Business Practice Location Address
First Line	:	475 E BRUNER AVE
Second Line	:	STE 130
City	:	HENDERSON
State	:	NV
Zip	:	89044
Country	:	US
Telephone Number	:	702-763-2263
Fax Number	:	702-723-3765

Authorized Official
Title or Position	:	MANAGER
Name	:	CHARLES HUTCHINGS
Credential	:	DO
Telephone Number	:	801-703-6235

Provider Enumeration Date	:	03/24/2023
Last Update Date	:	03/20/2026

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