Individual provider Active NPI

Nadine Vivarelli

  • Cognitive & Behavioral Psychologist
  • Las Vegas, NV
National Provider Identifier
1083026058
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Practice address
2655 S Raibow Blvd
#407
Las Vegas, NV 89146-5100
Phone
(702) 750-2682
Fax
(702) 750-9180
NPI assigned
May 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X Primary

Addresses

Primary practice location

2655 S Raibow Blvd
#407
Las Vegas, NV 89146-5100

Mailing address

2655 S Raibow Blvd
#407
Las Vegas, NV 89146-5100
Phone (702) 750-2682

Other identifiers 1

IdentifierTypeStateIssuer
1912294554MedicaidNV

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

Practice roles

OrganizationSpecialtyStatusNew patients
Remedy Services 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1083026058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 S RAIBOW BLVD",
            "address_2": "#407",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465100",
            "telephone_number": "702-750-2682",
            "fax_number": "702-750-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 S RAIBOW BLVD",
            "address_2": "#407",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465100",
            "telephone_number": "702-750-2682",
            "fax_number": "702-750-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVARELLI",
        "first_name": "NADINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-27",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912294554",
            "state": "NV"
        }
    ],
    "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 May 27, 2014; 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.