Department of Veterans Affairs

Primary specialty

Military HospitalTaxonomy code 286500000X

License

RN 22304 Issued in NV

Legal business name

DEPARTMENT OF VETERANS AFFAIRS

Practice address

4700 North Las Vegas Blvd.
Nellis Air Force Base
Las Vegas, NV 89191-6601

Phone

(702) 653-3172

NPI assigned

May 5, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Marietta A. Cabillo, MSN, RN, BC

Title

Nurse Clinical Coordinator

Phone

(702) 653-3172

Specialties & licenses 1

Addresses

Other names 1

• Mike O'Callaghan Federal Hospital Doing business as

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1093981672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WELLSPRING AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837616",
            "telephone_number": "702-653-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 NORTH LAS VEGAS BLVD.",
            "address_2": "NELLIS AIR FORCE BASE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891916601",
            "telephone_number": "702-653-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "CABILLO",
        "authorized_official_first_name": "MARIETTA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "NURSE CLINICAL COORDINATOR",
        "authorized_official_telephone_number": "702-653-3172",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN, RN, BC"
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "NV",
            "license": "RN 22304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mike O'Callaghan Federal Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roger David Deo, R.N.
• Baljit Singh Deol, M.D.
• Jaskiran K Deol, DDS
• Melissa Ann Depa, PH.D.
• Depalo LLC
• Department of Veterans Affairs
• Elizabeth Grace Depass
• Destinee Depaulis
• Dependable Care Services LLC
• Dependable Diagnostics Center, Inc.

• Military Hospital in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Military Hospital in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.