Individual provider Active NPI

Juana Marina Cordon

  • Personal Care Attendant
  • Las Vegas, NV
National Provider Identifier
1548813595
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
2105773656 Issued in NV
Practice address
2300 Clifford Ave Apt 65
Las Vegas, NV 89104-2142
Phone
(702) 773-1349
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 2105773656 NV Primary

Addresses

Primary practice location

2300 Clifford Ave Apt 65
Las Vegas, NV 89104-2142

Mailing address

2300 Clifford Ave Apt 65
Las Vegas, NV 89104-2142
Phone (702) 773-1349

Other identifiers 1

IdentifierTypeStateIssuer
2105773656OtherNVIDENTIFICATION CARD

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

State licenses

LicenseStateTypeSpecialty
2105773656NVMDPersonal Care Attendant

NPI Registry JSON

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1548813595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CLIFFORD AVE APT 65",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891042142",
            "telephone_number": "702-773-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CLIFFORD AVE APT 65",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891042142",
            "telephone_number": "702-773-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDON",
        "first_name": "JUANA",
        "middle_name": "MARINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NV",
            "license": "2105773656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDENTIFICATION CARD",
            "identifier": "2105773656",
            "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 Jul 18, 2019; 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.