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NPI Code Detail

MEDICARE: IN A VISIT LLC

MEDICARE: IN A VISIT 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
1261QU0200XUrgent Care Clinic/Center
2261QX0100XOccupational Medicine Clinic/Center
3261QR1300XRural Health Clinic/Center
4164W00000XLicensed Practical Nurse
5207LP2900XPain Medicine (Anesthesiology) Physician
6261QH0100XHealth Service Clinic/Center
7261QP2300XPrimary Care Clinic/Center
8261QP3300XPain Clinic/Center
9261QR0200XRadiology Clinic/Center
10261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11497712483OTHERNVNPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41013980580OTHERNVNPI
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
61912927229OTHERNVNPI

General Provider Information

NPI Number : 1336749811
Entity Type Code : Organization
Provider Name (Legal Business Name) : IN A VISIT LLC
Provider Business Mailing Address
First Line : 7021 SPRING MOUNTAIN RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-3818
Country : US
Telephone Number : 702-803-2222
Fax Number : 702-829-7269
Provider Business Practice Location Address
First Line : 7021 SPRING MOUNTAIN RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-3818
Country : US
Telephone Number : 702-803-2222
Fax Number : 702-829-7269
Authorized Official
Title or Position : COO
Name : QUENNIE MANUEL
Credential :
Telephone Number : 702-328-0787
Provider Enumeration Date : 10/26/2020
Last Update Date : 10/26/2020

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Directions to “IN A VISIT LLC ” Practice Location

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