Active NPI
Shanice Wortham
- Health Information Technician
- Las Vegas, NV
National Provider Identifier
1255190146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Information Technician
- License
- 3981965
- Practice address
- 25 N 26TH St
Las Vegas, NV 89101-4619 - Phone
- (562) 589-2344
- NPI assigned
- Mar 14, 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 |
|---|---|---|---|---|
| Health Information Technician | 247000000X | 3981965 | NV | Primary |
Addresses
Primary practice location
25 N 26TH St
Las Vegas, NV 89101-4619
Mailing address
25 N 26TH St
Las Vegas, NV 89101-4619
Phone (562) 589-2344
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 |
|---|---|---|---|
| 3981965 | NV | MD | Health Information Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1255190146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 N 26TH ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891014619",
"telephone_number": "562-589-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 N 26TH ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891014619",
"telephone_number": "562-589-2344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTHAM",
"first_name": "SHANICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-14",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "247000000X",
"taxonomy_group": "",
"desc": "Technician, Health Information",
"state": "NV",
"license": "3981965",
"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 Mar 14, 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.