Individual provider Active NPI

Samantha Chloe Fernandez

  • Rehabilitation Practitioner
  • Las Vegas, NV
National Provider Identifier
1043567142
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
5230 W Patrick LN Ste 140
Las Vegas, NV 89118-5852
Phone
(702) 570-5100
NPI assigned
Aug 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X NV Primary

Addresses

Primary practice location

5230 W Patrick LN Ste 140
Las Vegas, NV 89118-5852

Mailing address

11935 Wedgebrook St
Las Vegas, NV 89183-5665
Phone (808) 391-3798

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": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1043567142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11935 WEDGEBROOK ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891835665",
            "telephone_number": "808-391-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 W PATRICK LN STE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891185852",
            "telephone_number": "702-570-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "SAMANTHA",
        "middle_name": "CHLOE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NV",
            "license": null,
            "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 7, 2012; 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.