Active NPI
Lara Joy Sultan, FNTP, CPT
- Nutritionist
- North Las Vegas, NV
National Provider Identifier
1124758750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 3305
- Practice address
- 112 Spur Ranch Ave
North Las Vegas, NV 89032-8108 - Phone
- (760) 518-9431
- NPI assigned
- Jun 15, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 3305 | WA | Primary |
Addresses
Primary practice location
112 Spur Ranch Ave
North Las Vegas, NV 89032-8108
Mailing address
PO Box 8626
Hot Springs Village, AR 71910-8626
Phone (760) 518-9431
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 |
|---|---|---|---|
| 3305 | WA | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655251200000",
"number": "1124758750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8626",
"city": "HOT SPRINGS VILLAGE",
"state": "AR",
"postal_code": "719108626",
"telephone_number": "760-518-9431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 SPUR RANCH AVE",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890328108",
"telephone_number": "760-518-9431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULTAN",
"first_name": "LARA",
"middle_name": "JOY",
"credential": "FNTP, CPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-15",
"last_updated": "2022-06-15",
"certification_date": "2022-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nutritionist",
"state": "WA",
"license": "3305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.