OrganizationActive
Provenance Healthcare LLC
NPI 1316322738 · Genetic Counselor (M.S.) · Las Vegas, NV
Provenance Healthcare LLC is a Genetic Counselor (M.S.) organization in Las Vegas, NV (NPI 1316322738).
Provider details
- NPI number
- 1316322738
- Entity type
- Organization
- Primary specialty
- Genetic Counselor (M.S.)Other Service Providers
- Organization subpart
- No
- Authorized official
- Mark Black, Owner Operator(702) 478-2524
- License
- OTHER (NV)
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5155 S Durango Dr Ste 103
Las Vegas, NV 89113-0175
Phone: (702) 478-2524
Fax: (702) 735-9074
Street-level locationGet directions
Mailing address
5155 S Durango Dr Ste 103
Las Vegas, NV 89113-0175
Registry dates
- Enumerated
- 2015-07-27
- Last updated
- 2015-07-27
Frequently asked questions
- What is Provenance Healthcare LLC's NPI number?
- Provenance Healthcare LLC's National Provider Identifier (NPI) is 1316322738, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Provenance Healthcare LLC?
- Provenance Healthcare LLC is classified in the NPPES registry as Genetic Counselor (M.S.) (Other Service Providers).
- Where is Provenance Healthcare LLC located?
- Provenance Healthcare LLC's practice location on file with NPPES is 5155 S Durango Dr Ste 103, Las Vegas, NV 89113-0175.
- What is Provenance Healthcare LLC's phone number?
- The practice phone number listed in the NPPES registry for Provenance Healthcare LLC is (702) 478-2524.
- Who is the authorized official for Provenance Healthcare LLC?
- The authorized official listed on Provenance Healthcare LLC's NPPES record is Mark Black, Owner Operator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Provenance Healthcare LLC's NPI active?
- Yes — Provenance Healthcare LLC's NPI (1316322738) is active in the NPPES registry as of the last update on 2015-07-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.