Individual provider Active NPI

Rosa Alma Hermosillo

  • Personal Care Attendant
  • Las Vegas, NV
National Provider Identifier
1033854633
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
G68-042555 Issued in NV
Practice address
1098 E Sahara Ave Ste 103
Las Vegas, NV 89104-3220
Phone
(702) 764-8639
NPI assigned
Apr 28, 2022
Last updated
Apr 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X G68-042555 NV Primary

Addresses

Primary practice location

1098 E Sahara Ave Ste 103
Las Vegas, NV 89104-3220

Mailing address

1098 E Sahara Ave Ste 103
Las Vegas, NV 89104-3220
Phone (702) 764-8639

Other identifiers 1

IdentifierTypeStateIssuer
1578169702MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NA Other

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
G68-042555NVMDPersonal Care Attendant

NPI Registry JSON

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1033854633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 E SAHARA AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043220",
            "telephone_number": "702-764-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 E SAHARA AVE STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043220",
            "telephone_number": "702-764-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMOSILLO",
        "first_name": "ROSA",
        "middle_name": "ALMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NV",
            "license": "G68-042555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578169702",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "NA",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NONE",
            "address_1": "1098 E Sahara Ave Ste 103",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891043220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Apr 28, 2022; 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.