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ARK MEDICAL OF LAS VEGAS LLC
NPI 1073394748
Nurse Practitioner - Family in Las Vegas, NV

Active since October 10, 2023CLIA 29D2320165 · Waiver
2820 W CHARLESTON BLVD STE D40, LAS VEGAS, NV 89102(725) 205-0288(725) 204-9792 Get Directions Write a Review

NPPES record last updated: January 14, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 2, 2024, Nov 5, 2023, Oct 10, 2023 (3 updates tracked since 2023).

About Ark Medical Of Las Vegas Llc NPPES

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

ARK MEDICAL OF LAS VEGAS LLC (NPI 1073394748) is a healthcare organization registered as a family in Las Vegas, Nevada and active in the NPI registry since October 2023. The organization holds a CLIA Waiver certificate valid through March 12, 2027 and lists Cecilio P Gonzales, President/owner, as its authorized official.

NPPES Registry Identity

NPI1073394748
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameARK MEDICAL OF LAS VEGAS LLC
Location Address2820 W CHARLESTON BLVD STE D40Las Vegas, NV 89102-1942
Mailing Address7521 Slipper Orchid StLas Vegas, NV 89148-2616 · (619) 259-7118
Phone(725) 205-0288
Fax(725) 204-9792
Organization SubpartNo
Authorized OfficialCecilio P GonzalesPresident/owner · (619) 259-7118
Enumeration DateOctober 10, 2023
Last NPPES UpdateJanuary 14, 20243 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2024
✔ NPI 1073394748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
2820 W CHARLESTON BLVD STE D40, Las Vegas, NV 89102
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CLIA Laboratory Certificates CMS CLIA

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 29D2320165

Ark Medical Of Las Vegas LLC · Las Vegas, NV
Active · expires Mar 12, 2027
CLIA Number29D2320165
Laboratory TypePractitioner Other
Certificate Effective DateMarch 13, 2025
Certificate Expiration DateMarch 12, 2027
Laboratory DirectorCecilio P. Gonzales
Laboratory Phone(725) 205-0288
Laboratory LocationArk Medical Of Las Vegas LLC2820 W Charleston Blvd Suite D40, Las Vegas, NV 89102
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CECILIO PARROCHA GONZALES JR. APRN,FNP-C, PMHNP-BC
Nurse Practitioner (Family)
2820 W CHARLESTON BLVD STE D40
LAS VEGAS, NV 89102
Clark County (725) 205-0288

Frequently Asked Questions

What is ARK MEDICAL OF LAS VEGAS LLC's NPI number?

The NPI number assigned to this healthcare provider is 1073394748, enumerated as an "organization" on October 10, 2023.

Where is the provider located?

The provider is located at 2820 W CHARLESTON BLVD STE D40 LAS VEGAS, NV 89102 and the phone number is (725) 205-0288.

What is the provider's specialty?

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.