| Omnia Care Physician Services LLC | |
|
350 Falcon Ridge Pkwy Ste 101 Mesquite NV 89027-8879 | |
| (702) 849-0585 | |
| (702) 849-0614 |
| Full Name | Omnia Care Physician Services LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 350 Falcon Ridge Pkwy Ste 101, Mesquite, Nevada |
| Authorized Official Name and Position | William S Hokanson (MEMBER) |
| Authorized Official Contact | 4352298882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omnia Care Physician Services LLC 350 Falcon Ridge Pkwy Ste 101 Mesquite NV 89027-8879 Ph: (702) 849-0585 | Omnia Care Physician Services LLC 350 Falcon Ridge Pkwy Ste 101 Mesquite NV 89027-8879 Ph: (702) 849-0585 |
| NPI Number | 1659018018 |
|---|---|
| Provider Enumeration Date | 05/17/2022 |
| Last Update Date | 05/16/2023 |
| Certification Date | 05/16/2023 |
| Medicare PECOS PAC ID | 1951756881 |
|---|---|
| Medicare Enrollment ID | O20231012003992 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659018018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Secondary |
| 207RH0002X | Internal Medicine - Hospice And Palliative Medicine | (NU) | Primary |
| Provider Name | Haley Elizabeth Morse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053627919 PECOS PAC ID: 4082912167 Enrollment ID: I20160406002279 |
| Provider Name | Lonny Dee Krause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528523206 PECOS PAC ID: 0547595522 Enrollment ID: I20200519001933 |
| Provider Name | Leah Gaitho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194355107 PECOS PAC ID: 1759706179 Enrollment ID: I20200803000733 |
| Provider Name | Justin Gomez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336854504 PECOS PAC ID: 7618340852 Enrollment ID: I20230308002577 |
| Provider Name | Jerry Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891475257 PECOS PAC ID: 2062869753 Enrollment ID: I20231117001550 |
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