Individual provider Active NPI

Angela Denise Mayes Shepherd

  • Home Health Agency
  • Las Vegas, NV
National Provider Identifier
1104508019
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
3430 E Flamingo Rd Ste 200
Las Vegas, NV 89121-5064
Phone
(702) 427-4000
NPI assigned
Aug 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3430 E Flamingo Rd Ste 200
Las Vegas, NV 89121-5064

Mailing address

450 S Decatur Blvd Unit 232
Las Vegas, NV 89107-2873
Phone (414) 435-4441

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

NPI Registry JSON

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1104508019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S DECATUR BLVD UNIT 232",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072873",
            "telephone_number": "414-435-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 E FLAMINGO RD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215064",
            "telephone_number": "702-427-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYES SHEPHERD",
        "first_name": "ANGELA",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "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 Aug 1, 2023; 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.