Individual provider Active NPI

Samantha Sidun

  • Electroneurodiagnostic Specialist/Technologist
  • Las Vegas, NV
National Provider Identifier
1003696170
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
Practice address
7455 W Washington Ave Ste 302
Las Vegas, NV 89128-4340
Phone
(855) 864-4322
NPI assigned
Oct 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X Primary

Addresses

Primary practice location

7455 W Washington Ave Ste 302
Las Vegas, NV 89128-4340

Mailing address

3000 Hillsboro Pike Apt 45
Nashville, TN 37215-1315
Phone (732) 977-6975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1003696170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 HILLSBORO PIKE APT 45",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372151315",
            "telephone_number": "732-977-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7455 W WASHINGTON AVE STE 302",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891284340",
            "telephone_number": "855-864-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDUN",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.