Individual provider Active NPI

Kristy Rose Sica

  • Behavior Analyst
  • Las Vegas, NV
National Provider Identifier
1013474295
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
5370 Angler Cir Unit 202
Las Vegas, NV 89122-7342
Phone
(702) 986-3969
NPI assigned
Feb 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

5370 Angler Cir Unit 202
Las Vegas, NV 89122-7342

Mailing address

8174 Las Vegas Blvd S # 96
Las Vegas, NV 89123-1029
Phone (702) 986-3969

Other identifiers 1

IdentifierTypeStateIssuer
2000591746MedicaidNV

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": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1013474295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8174 LAS VEGAS BLVD S # 96",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891231029",
            "telephone_number": "702-986-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5370 ANGLER CIR UNIT 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891227342",
            "telephone_number": "702-986-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICA",
        "first_name": "KRISTY",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000591746",
            "state": "NV"
        }
    ],
    "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 Feb 25, 2019; 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.