Active NPI
Desiree Dolores Anglin
- In Home Supportive Care Agency
- Las Vegas, NV
National Provider Identifier
1235967407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 3747A0650X
- Practice address
- 4558 Royal Ridge Ave
Las Vegas, NV 89103-5047 - Phone
- (702) 689-6067
- NPI assigned
- Jul 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 3747A0650X | NV | Primary |
Addresses
Primary practice location
4558 Royal Ridge Ave
Las Vegas, NV 89103-5047
Mailing address
4558 Royal Ridge Ave
Las Vegas, NV 89103-5047
Phone (702) 689-6067
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3747A0650X | NV | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1235967407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4558 ROYAL RIDGE AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891035047",
"telephone_number": "702-689-6067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4558 ROYAL RIDGE AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891035047",
"telephone_number": "702-689-6067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGLIN",
"first_name": "DESIREE",
"middle_name": "DOLORES",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-22",
"last_updated": "2024-07-22",
"certification_date": "2024-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "NV",
"license": "3747A0650X",
"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 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.