Active NPI
Evelyn Padre Padre, MD
- Family Medicine Physician
- Las Vegas, NV
National Provider Identifier
1215041223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 10365
- Practice address
- 2410 Fire Mesa St
Las Vegas, NV 89128-9016 - Phone
- (702) 636-6320
- Fax
- (702) 636-4020
- NPI assigned
- Aug 18, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10365 | NV | Primary |
Addresses
Primary practice location
2410 Fire Mesa St
Las Vegas, NV 89128-9016
Mailing address
4057 Perfect Lure St
Las Vegas, NV 89129-6089
Phone (702) 658-4613
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10365 | NV | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215041223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4057 PERFECT LURE ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891296089",
"telephone_number": "702-658-4613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 FIRE MESA ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891289016",
"telephone_number": "702-636-6320",
"fax_number": "702-636-4020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADRE",
"first_name": "EVELYN",
"middle_name": "PADRE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "10365",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.