Active NPI
Samuel Wilson
- Behavior Technician
- Henderson, NV
National Provider Identifier
1366372948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 1606556161
- Practice address
- 9089 S Pecos Rd Ste 3600
Henderson, NV 89074-7186 - Phone
- (702) 680-1526
- NPI assigned
- May 23, 2026
- Last updated
- May 23, 2026
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 1606556161 | NV | Primary |
Addresses
Primary practice location
9089 S Pecos Rd Ste 3600
Henderson, NV 89074-7186
Mailing address
9089 S Pecos Rd Ste 3600
Henderson, NV 89074-7186
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 |
|---|---|---|---|
| 1606556161 | NV | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779494400000",
"number": "1366372948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9089 S PECOS RD STE 3600",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890747186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9089 S PECOS RD STE 3600",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890747186",
"telephone_number": "702-680-1526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-23",
"last_updated": "2026-05-23",
"certification_date": "2026-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NV",
"license": "1606556161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.