Individual provider Active NPI

Gina Nicole Venditti, P.A.

  • Medical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1477579829
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 1224 Issued in NV
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

Updated by the provider on Sep 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PA9102437FLMDPhysician Assistant
PA 1224NVMDMedical 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.

Verify at the official NPI Registry.