Johanna S. Fricke, M.D., Llc
LBN: Johanna S. Fricke, M.D., Llc
Johanna S. Fricke, M.D., Llc is an health care organization with primary practice located at 311 N Buffalo Dr Suite B, Las Vegas NV 89145-0375. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, Ambulatory Health Care Facilities / Developmental Disabilities, Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Ambulatory Health Care Facilities / Medical Specialty. Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics is the primary health care specialty.
Johanna S. Fricke, M.D., Llc can be contacted via phone (702) 877-2520, or through Fricke, Johanna via phone (702) 804-9065.
Contact Information
Primary practice address
311 N Buffalo Dr Suite B
Las Vegas NV 89145-0375
Phone: (702) 877-2520
Fax: (702) 877-2521
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | Nevada | |
| Ambulatory Health Care Facilities / Developmental Disabilities | 261QD1600X | Nevada | |
| Ambulatory Health Care Facilities / Adolescent and Children Mental Health | 261QM0855X | Nevada | |
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | Nevada |
Profile Details
| NPI number | 1790108264 |
|---|---|
| LBN Legal business name | Johanna S. Fricke, M.D., Llc |
| DBA Doing business as | |
| Authorized official | Fricke, Johanna Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 3rd, 2014 |
| Last updated | Mar 7th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790108264 | NPPES |
| Nevada | Other | 32876 | MEDICARE ID-TYPE UNSPECIFIED/MEDICARE |
| Nevada | MEDICAID | 002002223 | MEDICARE ID-TYPE UNSPECIFIED/MEDICARE |
| Nevada | Other | CS09750 | MEDICARE ID-TYPE UNSPECIFIED/MEDICARE |
| Nevada | Other | 003102223 | MEDICARE ID-TYPE UNSPECIFIED/MEDICARE |
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