Individual provider Active NPI

Tikva Darvish Butler, RN, APN

  • Obstetrics & Gynecology Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1366532434
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
00106 Issued in NV
Practice address
2860 E. Desert Inn Road
Las Vegas, NV 89121
Phone
(702) 796-9997
Fax
(702) 796-1440
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 00106 NV Primary

Addresses

Primary practice location

2860 E. Desert Inn Road
Las Vegas, NV 89121

Mailing address

8906 Spanish Ridge Ave
Suite 202
Las Vegas, NV 89148-1304
Phone (702) 330-3102

Other identifiers 1

IdentifierTypeStateIssuer
1366532434MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 4, 2025 through Jun 4, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
00106NVMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1366532434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 SPANISH RIDGE AVE",
            "address_2": "SUITE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481304",
            "telephone_number": "702-330-3102",
            "fax_number": "702-912-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 E. DESERT INN ROAD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89121",
            "telephone_number": "702-796-9997",
            "fax_number": "702-796-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "TIKVA",
        "middle_name": "DARVISH",
        "credential": "RN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NV",
            "license": "00106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366532434",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.