Provider Demographics
NPI:1669234340
Name:HEALTHWAYS MEDICAL GROUP LLC
Entity type:Organization
Organization Name:HEALTHWAYS MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LENTINI
Authorized Official - Suffix:JR
Authorized Official - Credentials:FNP-BC, PMHNP-BC
Authorized Official - Phone:702-518-9182
Mailing Address - Street 1:6149 S RAINBOW BLVD # W5
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-3250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6149 S RAINBOW BLVD # W5
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3250
Practice Address - Country:US
Practice Address - Phone:702-518-9182
Practice Address - Fax:702-710-2889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty