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Deactivated NPI 1699763466 Deactivated / Inactive NPI Male Practitioner

Mark Jay Nisgore , PA-C

Physician Assistant • Pahrump, NV

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mark Nisgore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 06, 2005
NPI Deactivation Date December 05, 2024
Total Practice Duration ~19 Years of Practice (2005 – 2024)

Professional Overview & Biography Verified Profile Summary

Mark Nisgore, PA-C was a registered Physician Assistant practicing in Pahrump, NV. Throughout an active medical career spanning 19 years, Mark Nisgore provided care at the practice location at 1430 E CALVADA BLVD until profile deactivation on 2024-12-05.

Practice Location & Contact Primary Location

Practice Address

1430 E Calvada Blvd
Ste 100

Pahrump, NV 890485824

Telephone 7757511555
Fax 7757511551
Associated Practice Facility / Clinic
🏢 Happyland Pediatrics Facility NPI 1932289105

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Pahrump, NV

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.2 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
10 Specialists

Practicing in Pahrump, NV (1097 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License NV PA737

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Tina Highlen , PA-C

Physician Assistant

NPI 1184692048

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 05, 2024

Record deactivated on December 05, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1430 E CALVADA BLVD, STE 100, PAHRUMP, NV 890485824 (Tel: 7757511555)

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Updated Business Mailing Address July 08, 2007

Registered at 5701 W CHARLESTON BLVD, STE 100, LAS VEGAS, NV 891461217 (Tel: 7028779514)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MARK NISGORE, PA C

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #PA737 in NV)

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Initial NPI Registration & Enumeration October 06, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1699763466
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 06, 2005
Last Update: July 08, 2007
Deactivation Date: December 05, 2024

Mailing Address

5701 W Charleston Blvd, Ste 100

Las Vegas, NV 891461217

Phone: 7028779514

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.