Individual provider Active NPI

Glaee G Valencia-Lopez, DC

  • Chiropractor
  • Las Vegas, NV
National Provider Identifier
1093784753
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
B01163 Issued in NV
Practice address
235 N Eastern Ave
#119
Las Vegas, NV 89101-4542
Phone
(702) 307-4004
Fax
(702) 307-9535
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X B01163 NV Primary

Addresses

Primary practice location

235 N Eastern Ave
#119
Las Vegas, NV 89101-4542

Mailing address

235 N Eastern Ave
#119
Las Vegas, NV 89101-4542
Phone (702) 307-4004

Other identifiers 1

IdentifierTypeStateIssuer
100508352MedicaidNV

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
B01163NVMDChiropractor

Networks

  • UT PPO D-SNP
  • UT PPO

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1093784753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 N EASTERN AVE",
            "address_2": "#119",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891014542",
            "telephone_number": "702-307-4004",
            "fax_number": "702-307-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N EASTERN AVE",
            "address_2": "#119",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891014542",
            "telephone_number": "702-307-4004",
            "fax_number": "702-307-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA-LOPEZ",
        "first_name": "GLAEE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B01163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508352",
            "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 Mar 3, 2009; 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.