Individual provider Active NPI

Nicola Adams

  • Rehabilitation Practitioner
  • Boulder City, NV
National Provider Identifier
1043899115
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
200 Wilson Cir
Boulder City, NV 89005-4401
Phone
(702) 294-7100
Fax
(702) 294-7171
NPI assigned
Apr 6, 2021
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
St. Jude'S Ranch for Children Rehabilitation Practitioner Current
since Apr 11, 2021
Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

NPPES NPI Registry

Primary practice location

200 Wilson Cir
Boulder City, NV 89005-4401

Mailing address

200 Wilson Cir
Boulder City, NV 89005-4401
Phone (702) 294-7100

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 6, 2021.

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1043899115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WILSON CIR",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890054401",
            "telephone_number": "702-294-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WILSON CIR",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890054401",
            "telephone_number": "702-294-7100",
            "fax_number": "702-294-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "NICOLA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.