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NPI 1568850204ActiveOrganization· Preferred Provider Organization· Las Vegas, NV

Preferred Provider Organization in Las Vegas, Nevada, registered in NPPES in January 2015. The authorized official on file is Tyler Michael Bannister, President.

Overview

NPI1568850204
StatusActive
Entity typeOrganization
NPI issuedJan 5, 2015
Last updated in NPPESMay 9, 2016

Specialties and licenses

TaxonomyCodeLicenseState
Preferred Provider Organization Primary305R00000XNV201441740613NV

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Preferred Provider Organization providers in Las Vegas

All Preferred Provider Organization providers in Nevada →