Provider Demographics
NPI:1871456897
Name:PRISM CARE PLLC
Entity type:Organization
Organization Name:PRISM CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASISTIO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:702-427-8909
Mailing Address - Street 1:750 CORONADO CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5035
Mailing Address - Country:US
Mailing Address - Phone:702-760-7761
Mailing Address - Fax:702-760-1677
Practice Address - Street 1:750 CORONADO CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5035
Practice Address - Country:US
Practice Address - Phone:702-760-7761
Practice Address - Fax:702-760-1677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion
No305S00000XManaged Care OrganizationsPoint of Service