Active NPI
Heather Waldroup
- Home Health Aide
- Las Vegas, NV
National Provider Identifier
1417543190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 2700 E Sunset Rd Ste 17
Las Vegas, NV 89120-3508 - Phone
- (702) 476-8809
- NPI assigned
- Dec 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Primary |
Addresses
Primary practice location
2700 E Sunset Rd Ste 17
Las Vegas, NV 89120-3508
Mailing address
2700 E Sunset Rd Ste 17
Las Vegas, NV 89120-3508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6733493 | Medicaid | AK |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1417543190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 E SUNSET RD STE 17",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891203508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 E SUNSET RD STE 17",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891203508",
"telephone_number": "702-476-8809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDROUP",
"first_name": "HEATHER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-16",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6733493",
"state": "AK"
}
],
"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 Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.