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CENTENNIAL MEDICAL GROUP LLP
NPI 1013807361
Durable Medical Equipment & Medical Supplies in Las Vegas, NV

Active since July 08, 2025CLIA Certified · 3 labs
4050 E RUSSELL RD STE 100, LAS VEGAS, NV 89120(702) 893-1203 Get Directions Write a Review

NPPES record last updated: July 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Centennial Medical Group Llp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTENNIAL MEDICAL GROUP LLP (NPI 1013807361) is a healthcare organization registered as a durable medical equipment & medical supplies in Las Vegas, Nevada and active in the NPI registry since July 2025. The organization holds 3 active CLIA laboratory certificates and lists Kellie Merrill, Director Of Billing, as its authorized official.

NPPES Registry Identity

NPI1013807361
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameCENTENNIAL MEDICAL GROUP LLP
Location Address4050 E RUSSELL RD STE 100Las Vegas, NV 89120-3810
Mailing Address4454 N Decatur BlvdLas Vegas, NV 89130-5286 · (702) 893-1203 · Fax (702) 893-1301
Phone(702) 893-1203
Organization SubpartNo
Authorized OfficialKellie MerrillDirector Of Billing · (702) 839-1203
Enumeration DateJuly 8, 2025
NPPES CertifiedJuly 8, 2025
✔ NPI 1013807361 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
4050 E RUSSELL RD STE 100, Las Vegas, NV 89120
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CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 29D1097817

Centennial Medical Group Llp-N Decatur · Las Vegas, NV
Active · expires Apr 2, 2027
CLIA Number29D1097817
Laboratory TypePhysician Office
Certificate Effective DateApril 3, 2025
Certificate Expiration DateApril 2, 2027
Laboratory DirectorDavid R. Lanzkowsky
Laboratory Phone(702) 839-1203
Laboratory LocationCentennial Medical Group Llp-N Decatur4454 N Decatur Blvd, Las Vegas, NV 89130
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 29D2051864

Centennial Medical Group, Llp- Russell · Las Vegas, NV
Active · expires Dec 30, 2026
CLIA Number29D2051864
Laboratory TypePhysician Office
Certificate Effective DateDecember 31, 2024
Certificate Expiration DateDecember 30, 2026
Laboratory DirectorDavid R. Lanzkowsky
Laboratory Phone(702) 839-1203
Laboratory LocationCentennial Medical Group, Llp- Russell4050 E Russell Rd, Ste 100, Las Vegas, NV 89120
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 32D2323810

Centennial Medical Group Dba Centenial Spine And Pain · Albuquerque, NM
Active · expires May 13, 2027
CLIA Number32D2323810
Laboratory TypePhysician Office
Certificate Effective DateMay 14, 2025
Certificate Expiration DateMay 13, 2027
Laboratory DirectorJohn Watkins
Laboratory Phone(702) 839-1203
Laboratory LocationCentennial Medical Group Dba Centenial Spine And Pain7800 East Constitution Avenue, Albuquerque, NM 87110
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Centennial Medical Group LLP's NPI number?

The NPI number for Centennial Medical Group LLP is 1013807361. It was assigned to this organization in the NPPES registry on July 8, 2025.

Where is Centennial Medical Group LLP located?

Centennial Medical Group LLP is located at 4050 E Russell Rd Ste 100, Las Vegas, NV 89120. The listed phone number is (702) 893-1203.

What is Centennial Medical Group LLP's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Centennial Medical Group LLP hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Centennial Medical Group LLP was last updated on July 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.