1164370763 NPI number — LAS VEGAS VIP URGENT CARE, LLC

Table of content: WILLESHA LEWIS (NPI 1326996000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164370763 NPI number — LAS VEGAS VIP URGENT CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAS VEGAS VIP URGENT CARE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164370763
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7435 S. EASTERN AVE, STE 105
Provider Second Line Business Mailing Address:
#142
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89123-1505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-252-5144
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2971 S SAMMY DAVIS JR DR
Provider Second Line Business Practice Location Address:
UNIT 130 & 132
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89109-1196
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-802-0243
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2026

Additional Information

Authorized Official

Authorized Official Last Name:
HASS
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
Authorized Official Title or Position:
NURSE PRACTITIONER
Authorized Official Telephone Number:
219-252-5144

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com