Individual provider Active NPI

Debra Ann Dirisio, RPH

  • Pharmacist
  • Las Vegas, NV
National Provider Identifier
1235446386
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8837 Issued in NV
Practice address
6555 N Decatur Blvd
Las Vegas, NV 89131-2796
Phone
(702) 415-2328
Fax
(702) 415-2325
NPI assigned
Sep 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8837 NV Primary

Addresses

Primary practice location

6555 N Decatur Blvd
Las Vegas, NV 89131-2796

Mailing address

6555 N Decatur Blvd
Las Vegas, NV 89131-2796
Phone (702) 415-2328

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
8837NVMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1235446386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 N DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891312796",
            "telephone_number": "702-415-2328",
            "fax_number": "702-415-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 N DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891312796",
            "telephone_number": "702-415-2328",
            "fax_number": "702-415-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRISIO",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "8837",
            "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 Sep 10, 2010; 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.