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JAGANNATH S. SURPURE M.D.P.C. NPI 1750422481


NPI Information

NPI: 1750422481
Provider Name: JAGANNATH S. SURPURE, M.D.P.C.

Doing Business As: CHILDREN'S URGENT CARE & PEDIATRIC CLINIC

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 29D1014780

Address:
1600 W SUNSET RD
SUITE A
HENDERSON, NV
ZIP 89014
Phone: (702) 898-6400
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JAGANNATH S. SURPURE, M.D.P.C. is a pediatrics in Henderson, NV. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. JAGANNATH S. SURPURE, M.D.P.C. NPI is 1750422481. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Children's Urgent Care & Pediatric Clinic.

The provider's business location address is:

1600 W SUNSET RD
SUITE A
HENDERSON, NV
ZIP 89014-654
Phone: (702) 898-6400
Fax: (702) 898-7032

The provider's authorized official is Jagannath S. Surpure .
The authorized official title is Medical Director and has the following contact phone number (702) 898-6400.

The CLIA number assigned to this NPI record is 29D1014780 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 8/22/2020.


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
1208000000XPediatrics6591NEVADAYes

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
13102430MEDICAIDNEVADA
22019436MEDICAIDNEVADA

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.