Individual provider Active NPI

Pamela Nyon, OD

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1144387309
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
505 Issued in NV
Practice address
3041 N Rainbow Blvd
Ste. 1
Las Vegas, NV 89108-4577
Phone
(702) 645-8573
Fax
(702) 839-5386
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 505 NV Primary
Optometrist 152W00000X 12635 T CA

Addresses

Primary practice location

3041 N Rainbow Blvd
Ste. 1
Las Vegas, NV 89108-4577

Mailing address

3041 N Rainbow Blvd
Ste. 1
Las Vegas, NV 89108-4577
Phone (702) 645-8573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019000235 NV Practitioner - Optometry 5496948838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12635 TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1144387309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 N RAINBOW BLVD",
            "address_2": "STE. 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891084577",
            "telephone_number": "702-645-8573",
            "fax_number": "702-839-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 N RAINBOW BLVD",
            "address_2": "STE. 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891084577",
            "telephone_number": "702-645-8573",
            "fax_number": "702-839-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYON",
        "first_name": "PAMELA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "505",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12635 T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.