Active NPI
Olive Acedera Bayle
- Pharmacist
- Las Vegas, NV
National Provider Identifier
1043815046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19515
- Practice address
- 1425 W Lake Mead Blvd
Las Vegas, NV 89106-2423 - Phone
- (702) 638-2625
- Fax
- (702) 647-4291
- NPI assigned
- Nov 30, 2020
- Last updated
- Nov 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19515 | NV | Primary |
Addresses
Primary practice location
1425 W Lake Mead Blvd
Las Vegas, NV 89106-2423
Mailing address
1425 W Lake Mead Blvd
Las Vegas, NV 89106-2423
Phone (702) 638-2625
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19515 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warm Springs Road CVS LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1043815046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 W LAKE MEAD BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891062423",
"telephone_number": "702-638-2625",
"fax_number": "702-647-4291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 W LAKE MEAD BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891062423",
"telephone_number": "702-638-2625",
"fax_number": "702-647-4291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAYLE",
"first_name": "OLIVE",
"middle_name": "ACEDERA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "19515",
"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 Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.