Organization Active NPI

Wonderfully Made

  • Behavior Analyst
  • Las Vegas, NV
National Provider Identifier
1275806549
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
WONDERFULLY MADE
Practice address
4559 Sparwood Dr
Las Vegas, NV 89147-8212
Phone
(702) 994-1931
NPI assigned
Feb 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Authorized official

Name
Mrs. Sherita Thomas-McDade, LSW
Title
Owner
Phone
(702) 994-1931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

4559 Sparwood Dr
Las Vegas, NV 89147-8212

Mailing address

4559 Sparwood Dr
Las Vegas, NV 89147-8212
Phone (702) 994-1931

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1275806549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4559 SPARWOOD DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478212",
            "telephone_number": "702-994-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4559 SPARWOOD DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478212",
            "telephone_number": "702-994-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONDERFULLY MADE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "THOMAS-MCDADE",
        "authorized_official_first_name": "SHERITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-994-1931",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "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 Feb 17, 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.