Active NPI
Nathen Dale Connolly, PHARMD
- Pharmacist
- Las Vegas, NV
National Provider Identifier
1306278239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18540
- Practice address
- 2975 E Sahara Ave
Las Vegas, NV 89104-4114 - Phone
- (702) 457-8325
- NPI assigned
- Aug 1, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18540 | NV | Primary |
Addresses
Primary practice location
2975 E Sahara Ave
Las Vegas, NV 89104-4114
Mailing address
5509 Dalle Valley St
North Las Vegas, NV 89031-7846
Phone (702) 374-4116
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18540 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443571200000",
"number": "1306278239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5509 DALLE VALLEY ST",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890317846",
"telephone_number": "702-374-4116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2975 E SAHARA AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891044114",
"telephone_number": "702-457-8325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "NATHEN",
"middle_name": "DALE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-01",
"last_updated": "2015-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "18540",
"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 Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.