Active NPI
Rocky Villarama, CFA/CST
- Surgical Assistant
- Las Vegas, NV
National Provider Identifier
1376879809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 112380
- Practice address
- 1676 Jupiter CT
Suite D
Las Vegas, NV 89119-5809 - Phone
- (702) 480-2867
- Fax
- (702) 693-6595
- NPI assigned
- Oct 17, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 112380 | NV | Primary |
| Surgical Technologist | 246ZS0410X | 86492 | NV | |
| Other Technician | 247200000X | NV |
Addresses
Primary practice location
1676 Jupiter CT
Suite D
Las Vegas, NV 89119-5809
Mailing address
1676 Jupiter CT
Suite D
Las Vegas, NV 89119-5809
Phone (702) 480-2867
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 |
|---|---|---|---|
| 112380 | NV | MD | Surgical Assistant |
| 86492 | NV | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255737600000",
"number": "1376879809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1676 JUPITER CT",
"address_2": "SUITE D",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891195809",
"telephone_number": "702-480-2867",
"fax_number": "702-693-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1676 JUPITER CT",
"address_2": "SUITE D",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891195809",
"telephone_number": "702-480-2867",
"fax_number": "702-693-6595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLARAMA",
"first_name": "ROCKY",
"credential": "CFA/CST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-17",
"last_updated": "2009-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "NV",
"license": "112380",
"primary": true
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "NV",
"license": "86492",
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "NV",
"license": null,
"primary": false
}
],
"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 Oct 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.