Individual provider Active NPI

Bethzeba Dayda

  • Rehabilitation Practitioner
  • North Las Vegas, NV
National Provider Identifier
1588099303
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
5328 Summer Trout St
North Las Vegas, NV 89031-6616
Phone
(702) 493-7267
NPI assigned
Sep 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

5328 Summer Trout St
North Las Vegas, NV 89031-6616

Mailing address

5328 Summer Trout Street
North Las Vegas, NV 89031
Phone (702) 493-7267

Other identifiers 1

IdentifierTypeStateIssuer
225400000XMedicaidNV

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": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1588099303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5328 SUMMER TROUT STREET",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89031",
            "telephone_number": "702-493-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5328 SUMMER TROUT ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890316616",
            "telephone_number": "702-493-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAYDA",
        "first_name": "BETHZEBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225400000X",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North 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 11, 2013; 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.