Individual provider Active NPI

Miriam Medrano

  • Behavior Analyst
  • Las Vegas, NV
National Provider Identifier
1497485171
Registry record updated Jul 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
3035 S Jones Blvd Ste 1
Las Vegas, NV 89146-6766
Phone
(702) 829-1021
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

3035 S Jones Blvd Ste 1
Las Vegas, NV 89146-6766

Mailing address

6300 W Tropicana Ave
Las Vegas, NV 89103-4401
Phone (702) 601-6619

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

Practice roles

OrganizationSpecialtyStatusNew patients
Moving Mountains BX LLC Behavior Analyst CurrentSince May 14, 2023 Accepting new patients

Locations

3035 S Jones Blvd
Ste 1
Las Vegas, NV 89146
Phone (702) 829-1021

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1497485171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 W TROPICANA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034401",
            "telephone_number": "702-601-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 S JONES BLVD STE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466766",
            "telephone_number": "702-829-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "MIRIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "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 Jul 2, 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.

Verify at the official NPI Registry.