Individual provider Active NPI

Lianis Kirenia Martinez Chacon

  • Registered Nurse
  • Las Vegas, NV
National Provider Identifier
1114512605
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
860557 Issued in NV
Practice address
3930 Howard Hughes Pkwy Ste 300
Las Vegas, NV 89169-0946
Phone
(702) 569-2192
NPI assigned
Mar 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 860557 NV Primary

Addresses

Primary practice location

3930 Howard Hughes Pkwy Ste 300
Las Vegas, NV 89169-0946

Mailing address

5130 S Pecos Rd
Las Vegas, NV 89120-1201
Phone (702) 410-5090

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ICANOTES Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
860557NVMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Guanaroca Medical Center Inc CurrentSince Oct 10, 2021 Accepting new patients

Locations

5130 S Pecos Rd
Las Vegas, NV 89120
Phone (702) 410-5090

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1114512605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 S PECOS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201201",
            "telephone_number": "702-410-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 HOWARD HUGHES PKWY STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891690946",
            "telephone_number": "702-569-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ CHACON",
        "first_name": "LIANIS",
        "middle_name": "KIRENIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "860557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ICANOTES",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5130 S Pecos Rd",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891201201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jul 8, 2025; 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.