Individual provider Active NPI

Shadonna Latimore

  • Foster Care Agency
  • Las Vegas, NV
National Provider Identifier
1235475328
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
Practice address
3155 E Patrick LN
Las Vegas, NV 89120-3496
Phone
(702) 992-0576
Fax
(108) 992-0391
NPI assigned
Dec 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X Primary

Addresses

Primary practice location

3155 E Patrick LN
Las Vegas, NV 89120-3496

Mailing address

3155 E Patrick LN
Las Vegas, NV 89120-3496
Phone (702) 992-0576

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

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1235475328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 E PATRICK LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203496",
            "telephone_number": "702-992-0576",
            "fax_number": "108-992-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 E PATRICK LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203496",
            "telephone_number": "702-992-0576",
            "fax_number": "108-992-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIMORE",
        "first_name": "SHADONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "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 Dec 18, 2012; 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.