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ATHLETE ADVANTAGE MEDICAL LLC NPI 1578180469


NPI Information

NPI: 1578180469
Provider Name: ATHLETE ADVANTAGE MEDICAL LLC
Classification: Emergency Medicine - 207P00000X
Entity Type: Organization

CLIA Number: 29D2193188

Address:
6315 S RAINBOW BLVD STE 100
LAS VEGAS, NV
ZIP 89118
Phone: (800) 674-9515
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ATHLETE ADVANTAGE MEDICAL LLC is an emergency medicine in Las Vegas, NV. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. ATHLETE ADVANTAGE MEDICAL LLC NPI is 1578180469. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6315 S RAINBOW BLVD STE 100
LAS VEGAS, NV
ZIP 89118-217
Phone: (800) 674-9515
Fax: (702) 988-5154

The provider's authorized official is Nick Sadeghi .
The authorized official title is Owner and has the following contact phone number (702) 982-5938.

The CLIA number assigned to this NPI record is 29D2193188 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/26/2020 and was last updated on 5/4/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency MedicineYes
2207Q00000XFamily MedicineNo
3207RS0010XInternal MedicineSports MedicineNo
42084N0400XPsychiatry & NeurologyNeurologyNo
5225100000XPhysical TherapistNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100500132MEDICAIDNEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.