NPIMap

Individual provider Active NPI

Vicki Hom, MD

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1023043403
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9036 Issued in NV
Practice address
4570 S. Eastern Ave
Suite #21
Las Vegas, NV 89119-6183
Phone
(702) 733-6033
Fax
(702) 733-6033
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9036 NV Primary

Addresses

Primary practice location

4570 S. Eastern Ave
Suite #21
Las Vegas, NV 89119-6183

Mailing address

4570 S. Eastern Ave
Suite #21
Las Vegas, NV 89119-6183
Phone (702) 733-6033

Other identifiers 2

IdentifierTypeStateIssuer
002018599MedicaidNV
003102599MedicaidNV

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9036NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Springs Hospital Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1023043403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 S. EASTERN AVE",
            "address_2": "SUITE #21",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196183",
            "telephone_number": "702-733-6033",
            "fax_number": "702-733-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 S. EASTERN AVE",
            "address_2": "SUITE #21",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196183",
            "telephone_number": "702-733-6033",
            "fax_number": "702-733-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOM",
        "first_name": "VICKI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "9036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018599",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003102599",
            "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 Mar 8, 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.