Active NPI
Bernadette Ann Phillips
- In Home Supportive Care Agency
- Las Vegas, NV
National Provider Identifier
1477209609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 5300 Roseland Ave
Las Vegas, NV 89130-2635 - Phone
- (702) 349-0358
- NPI assigned
- Feb 25, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
5300 Roseland Ave
Las Vegas, NV 89130-2635
Mailing address
5300 Roseland Ave
Las Vegas, NV 89130-2635
Phone (702) 349-0358
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 880782977 | Medicaid | NV |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bernadette1365@hotmail.com |
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": "1645747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645747200000",
"number": "1477209609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 ROSELAND AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891302635",
"telephone_number": "702-349-0358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 ROSELAND AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891302635",
"telephone_number": "702-349-0358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "BERNADETTE",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-25",
"last_updated": "2022-02-25",
"certification_date": "2022-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "880782977",
"state": "NV"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bernadette1365@hotmail.com",
"affiliation": "N",
"endpointDescription": "bernadette1365@hotmail.com",
"address_1": "5300 Roseland Ave",
"city": "Las Vegas",
"state": "NV",
"country_code": "US",
"postal_code": "891302635",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.