Active NPI
Bertha Jeanie Banks
- Behavior Analyst
- N Las Vegas, NV
National Provider Identifier
1033401021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 4435 Matinee Ave
N Las Vegas, NV 89031-0417 - Phone
- (702) 696-8091
- NPI assigned
- May 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary | ||
| Psychologist | 103T00000X |
Addresses
Primary practice location
4435 Matinee Ave
N Las Vegas, NV 89031-0417
Mailing address
4435 Matinee Ave
N Las Vegas, NV 89031
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": "1304899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304899200000",
"number": "1033401021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4435 MATINEE AVE",
"city": "N LAS VEGAS",
"state": "NV",
"postal_code": "89031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4435 MATINEE AVE",
"city": "N LAS VEGAS",
"state": "NV",
"postal_code": "890310417",
"telephone_number": "702-696-8091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANKS",
"first_name": "BERTHA",
"middle_name": "JEANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-09",
"last_updated": "2011-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in N Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.