Active NPI
Gina Nicole Venditti, P.A.
- Medical Physician Assistant
- Las Vegas, NV
National Provider Identifier
1477579829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 1224
- Practice address
- 3758 Las Vegas Blvd S
Las Vegas, NV 89109-4132 - Phone
- (702) 262-9028
- Fax
- (702) 736-3921
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9102437 | FL | |
| Medical Physician Assistant | 363AM0700X | PA 1224 | NV | Primary |
Addresses
Primary practice location
3758 Las Vegas Blvd S
Las Vegas, NV 89109-4132
Mailing address
3758 Las Vegas Blvd S
Las Vegas, NV 89109-4132
Phone (702) 262-9028
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9102437 | FL | MD | Physician Assistant |
| PA 1224 | NV | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283817600000",
"number": "1477579829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3758 LAS VEGAS BLVD S",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891094132",
"telephone_number": "702-262-9028",
"fax_number": "702-736-3921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3758 LAS VEGAS BLVD S",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891094132",
"telephone_number": "702-262-9028",
"fax_number": "702-736-3921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENDITTI",
"first_name": "GINA",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2010-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9102437",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NV",
"license": "PA 1224",
"primary": true
}
],
"identifiers": [],
"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 Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.