Active NPI
Marveletta Kirk
- Rehabilitation Practitioner
- Henderson, NV
National Provider Identifier
1497022081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 6530 Annie Oakley Dr
512
Henderson, NV 89014-2167 - Phone
- (702) 239-6125
- Fax
- (702) 825-4873
- NPI assigned
- Nov 26, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
6530 Annie Oakley Dr
512
Henderson, NV 89014-2167
Mailing address
6530 Annie Oakley Dr
512
Henderson, NV 89014-2167
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NV20111675665 | Medicaid | NV |
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": "1322265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470009600000",
"number": "1497022081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6530 ANNIE OAKLEY DR",
"address_2": "512",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890142167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6530 ANNIE OAKLEY DR",
"address_2": "512",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890142167",
"telephone_number": "702-239-6125",
"fax_number": "702-825-4873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "MARVELETTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-26",
"last_updated": "2016-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NV20111675665",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.