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Provenance Healthcare LLC

Genetic Counselor (M.S.) in Las Vegas, NV · enumerated 2015 · authorized official Mark Black, Owner Operator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1316322738

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Registry record

Entity type Organization (Type 2)
Legal business name Provenance Healthcare LLC
Practice address 5155 S Durango Dr Ste 103, Las Vegas, NV, 89113
Phone (702) 478-2524
Fax (702) 735-9074
Enumeration date Jul 27, 2015
Last updated in NPPES Jul 27, 2015

Taxonomy & classification

170300000X Genetic Counselor (M.S.) Other Service Providers · License OTHER (NV) Primary

Authorized official

Name Mark Black
Title Owner Operator
Phone (702) 478-2524

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Provenance Healthcare LLC?
The NPI for Provenance Healthcare LLC is 1316322738, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Provenance Healthcare LLC?
NPPES lists Mark Black (Owner Operator) as the authorized official for this organization.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2015-07-27.