Individual provider Active NPI

Kristian Shaw

  • Licensed Practical Nurse
  • Las Vegas, NV
National Provider Identifier
1285593434
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
895060 Issued in NV
Practice address
9625 W Russell Rd Apt 2108
Las Vegas, NV 89148-4549
Phone
(678) 254-5045
NPI assigned
Jan 21, 2026
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 895060 NV Primary

Addresses

Primary practice location

9625 W Russell Rd Apt 2108
Las Vegas, NV 89148-4549

Mailing address

9625 W Russell Rd Apt 2108
Las Vegas, NV 89148-4549
Phone (678) 254-5045

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

LicenseStateTypeSpecialty
895060NVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1285593434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 W RUSSELL RD APT 2108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484549",
            "telephone_number": "678-254-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 W RUSSELL RD APT 2108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484549",
            "telephone_number": "678-254-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KRISTIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NV",
            "license": "895060",
            "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 Jan 21, 2026; 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.