NPIMap

Organization Active NPI

State of Nevada

  • Early Intervention Provider Agency
  • Las Vegas, NV
National Provider Identifier
1407084395
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
STATE OF NEVADA
Practice address
1161 S Valley View Blvd
Las Vegas, NV 89102-1854
Phone
(702) 486-7670
NPI assigned
Jun 30, 2009
Last updated
Jun 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Ms. Janelle Mulvenon
Title
Bureau Chief
Phone
(775) 688-0327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU Primary

Addresses

Primary practice location

1161 S Valley View Blvd
Las Vegas, NV 89102-1854

Mailing address

1161 S Valley View Blvd
Las Vegas, NV 89102-1854
Phone (702) 486-7670

Other identifiers 1

IdentifierTypeStateIssuer
002002024MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
State of Nevada Bureau125 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1407084395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 S VALLEY VIEW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021854",
            "telephone_number": "702-486-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 S VALLEY VIEW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021854",
            "telephone_number": "702-486-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "MULVENON",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_title_or_position": "BUREAU CHIEF",
        "authorized_official_telephone_number": "775-688-0327",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002002024",
            "state": "NV"
        }
    ],
    "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 Jun 30, 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.

Verify at the official NPI Registry.