Active NPI
Porscha Menyweather
- Clinical Child & Adolescent Psychologist
- Las Vegas, NV
National Provider Identifier
1275871238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Practice address
- 4316 E Tropicana Ave
Las Vegas, NV 89121-6704 - Phone
- (702) 420-0028
- NPI assigned
- Jan 26, 2013
- Last updated
- Jan 26, 2013
- 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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | NU | Primary |
Addresses
Primary practice location
4316 E Tropicana Ave
Las Vegas, NV 89121-6704
Mailing address
4316 E Tropicana Ave
Las Vegas, NV 89121-6704
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NV20121267098 | Medicaid | NV |
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": "1359158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359158400000",
"number": "1275871238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4316 E TROPICANA AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891216704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4316 E TROPICANA AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891216704",
"telephone_number": "702-420-0028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENYWEATHER",
"first_name": "PORSCHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-26",
"last_updated": "2013-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NV20121267098",
"state": "NV"
}
],
"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 Jan 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.