Individual provider Active NPI

Rhia Joy Lumanog Dizon, NP

  • Primary Care Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1386205052
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
821568 Issued in NV
Practice address
7003 Tidelands Park CT
Las Vegas, NV 89166-7132
Phone
(702) 426-1049
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 821568 NV Primary

Addresses

Primary practice location

7003 Tidelands Park CT
Las Vegas, NV 89166-7132

Mailing address

7003 Tidelands Park CT
Las Vegas, NV 89166-7132
Phone (702) 426-1049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191220001953 NV Practitioner - Nurse Practitioner 1153755343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Santa Rosa Medical Centers of Nevada IncGroup PAC ID 4587716964, 7 clinicians

Practice addresses (Care Compare)

4161 S Eastern Ave
Suite B3
Las Vegas, NV 89119-5483
Phone (702) 693-6222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
821568NVMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Medical Centers of Nevada, Inc. CurrentSince Mar 1, 2022 Accepting new patients

Locations

4161 S Eastern Ave
Ste B3
Las Vegas, NV 89119
Phone (702) 693-5891

7021 Spring Mountain Rd
Ste 213
Las Vegas, NV 89117

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1386205052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7003 TIDELANDS PARK CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891667132",
            "telephone_number": "702-426-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7003 TIDELANDS PARK CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891667132",
            "telephone_number": "702-426-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "RHIA JOY",
        "middle_name": "LUMANOG",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NV",
            "license": "821568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.