Active NPI
Cleautry H McDaniel Jr.
- Durable Medical Equipment & Medical Supplies
- Las Vegas, NV
National Provider Identifier
1497913420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Practice address
- 501 S Rancho Dr
#E33
Las Vegas, NV 89106-4828 - Phone
- (704) 476-4987
- Fax
- (702) 541-8377
- NPI assigned
- May 27, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
501 S Rancho Dr
#E33
Las Vegas, NV 89106-4828
Mailing address
501 S Rancho Dr
#E33
Las Vegas, NV 89106-4828
Phone (704) 476-4987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30-0474098 | Other | NV | FEDERAL TAX ID |
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": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1497913420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S RANCHO DR",
"address_2": "#E33",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064828",
"telephone_number": "704-476-4987",
"fax_number": "702-541-8377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S RANCHO DR",
"address_2": "#E33",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064828",
"telephone_number": "704-476-4987",
"fax_number": "702-541-8377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDANIEL",
"first_name": "CLEAUTRY",
"middle_name": "H",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-27",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "30-0474098",
"state": "NV"
}
],
"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 May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.