Active NPI
Krisma Desportes
- Registered Dietitian
- Nellis AFB, NV
National Provider Identifier
1427141449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 133V00000X
- Practice address
- 4700 North Las Vegas Blvd
Nellis AFB, NV 89115-2329 - Phone
- (702) 653-2901
- NPI assigned
- Oct 2, 2006
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 133V00000X | NV | Primary |
Addresses
Primary practice location
4700 North Las Vegas Blvd
Nellis AFB, NV 89115-2329
Mailing address
4700 Las Vegas Blvd N
Las Vegas, NV 89191-6600
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 |
|---|---|---|---|
| 133V00000X | NV | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248220800000",
"number": "1427141449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891916600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 NORTH LAS VEGAS BLVD",
"city": "NELLIS AFB",
"state": "NV",
"postal_code": "891152329",
"telephone_number": "702-653-2901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESPORTES",
"first_name": "KRISMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2009-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NV",
"license": "133V00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nellis AFB, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.