Alicia Laurie Purdum, BOCO, BOCP

Primary specialty

OrthotistTaxonomy code 222Z00000X

License

C52329 Issued in NV

Practice address

810 S Durango Dr Ste 100
Las Vegas, NV 89145-2487

Phone

(702) 932-1300

Fax

(702) 848-4990

NPI assigned

Aug 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Children'S Orthotics and Prosthetics LLC

  • Prosthetic/Orthotic Supplier
  • Las Vegas, NV
  • NPI 1376069229

  Orthotist

  NPD Authorized official
• Portney Medical Group LTD

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1962604884
  NPD (past)

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043735871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S DURANGO DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891452487",
            "telephone_number": "702-932-1300",
            "fax_number": "702-848-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S DURANGO DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891452487",
            "telephone_number": "702-932-1300",
            "fax_number": "702-848-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDUM",
        "first_name": "ALICIA",
        "middle_name": "LAURIE",
        "credential": "BOCO, BOCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NV",
            "license": "C52329",
            "primary": false
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "NV",
            "license": "C52329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Purcell, LMSW
• Taylor Morgan Purcell
• Denise D. Purdie-Goodwin
• Tamiko Lachum Purdie
• Robert Lee Purdue III
• Elizabeth Purdy
• Jennifer Monique Purdy
• Nicole Purdy, A.A. PSYCHOLOGY
• Pure Counseling LLC
• Pure Dental

• Orthotist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Orthotist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.