Individual provider Active NPI

Kara Marie Balduzzi, PHARMD

  • Pharmacist
  • Las Vegas, NV
National Provider Identifier
1174809107
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18074 Issued in NV
Practice address
3150 N Tenaya Way Ste 170
Las Vegas, NV 89128-0462
Phone
(702) 256-2059
NPI assigned
Oct 21, 2011
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18074 NV Primary

Addresses

Primary practice location

3150 N Tenaya Way Ste 170
Las Vegas, NV 89128-0462

Mailing address

3150 N Tenaya Way Ste 170
Las Vegas, NV 89128-0462
Phone (702) 256-2059

Other identifiers 1

IdentifierTypeStateIssuer
18074OtherNVNEVADA STATE BOARD OF PHARMACY

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
Credentials
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Dec 28, 2022 Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Dec 28, 2022 Accepting new patients

Locations

3150 N Tenaya Way
Ste 170
Las Vegas, NV 89128
Phone (615) 419-9214

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1174809107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 N TENAYA WAY STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280462",
            "telephone_number": "702-256-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N TENAYA WAY STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280462",
            "telephone_number": "702-256-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDUZZI",
        "first_name": "KARA",
        "middle_name": "MARIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "18074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE BOARD OF PHARMACY",
            "identifier": "18074",
            "state": "NV"
        }
    ],
    "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 20, 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.

Verify at the official NPI Registry.