Active NPI
Tammy M Wild
- Registered Dietitian
- Las Vegas, NV
National Provider Identifier
1114223674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 32050DI-1
- Practice address
- 1800 W Charleston Blvd
Las Vegas, NV 89102-2329 - Phone
- (702) 383-2000
- NPI assigned
- Feb 1, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 32050DI-1 | NV | Primary |
Addresses
Primary practice location
1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Mailing address
1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-2000
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32050DI-1 | NV | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450742400000",
"number": "1114223674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 W CHARLESTON BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891022329",
"telephone_number": "702-383-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 W CHARLESTON BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891022329",
"telephone_number": "702-383-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILD",
"first_name": "TAMMY",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-01",
"last_updated": "2015-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NV",
"license": "32050DI-1",
"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 Dec 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.