Individual provider Active NPI

Deborah Renee Racine

  • Licensed Practical Nurse
  • Las Vegas, NV
National Provider Identifier
1013790997
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
838138 Issued in NV
Practice address
413 Davenport LN
Las Vegas, NV 89107-2453
Phone
(702) 913-3950
NPI assigned
Aug 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 838138 NV Primary

Addresses

Primary practice location

413 Davenport LN
Las Vegas, NV 89107-2453

Mailing address

413 Davenport LN
Las Vegas, NV 89107-2453
Phone (702) 913-3950

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

State licenses

LicenseStateTypeSpecialty
838138NVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1013790997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 DAVENPORT LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072453",
            "telephone_number": "702-913-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 DAVENPORT LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072453",
            "telephone_number": "702-913-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACINE",
        "first_name": "DEBORAH",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NV",
            "license": "838138",
            "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 Aug 15, 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.