Charissma J Clifton, M.ED

Key facts

NPI

1104609940

Entity type

Individual (NPI type 1)

Primary specialty

Contractor 171W00000X

Practice address

2740 S Jones Blvd Ste F
Las Vegas, NV 89146-5398

Phone

(702) 248-8866

NPI assigned

Aug 16, 2023

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Education

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 16, 2023.

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1104609940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9257 PALMER HOUSE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 S JONES BLVD STE F",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465398",
            "telephone_number": "702-248-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "CHARISSMA",
        "middle_name": "J",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

• Craig A Clifford, D.O.
• Ivana Yanella Clifford
• Jenna Leigh Clifford, LCSW
• Michael E Clifford, MICHAEL CLIFFORD MD
• Anthony Bernard Clifton
• Larrisha Clifton
• Lizet Climent
• Lauren Cline, RD, LD
• Lindsay Karoline Cline
• Tatyana Clines

All providers in Las Vegas, NV · Contractor in Nevada