MEDICARE: UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1790576692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA

Provider Business Mailing Address
First Line	:	1800 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2329
Country	:	US
Telephone Number	:	702-383-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5409 E LAKE MEAD BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89156-6709
Country	:	US
Telephone Number	:	702-383-2000
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	WILLIAM MASON VANHOUWELING
Credential	:
Telephone Number	:	702-383-2000

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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