Active NPI
Brandi Nicole Dobbertin, PA-C
- Physician Assistant
- Las Vegas, NV
National Provider Identifier
1588896948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1179
- Practice address
- 1350 E Flamingo Rd
13B, Box 309
Las Vegas, NV 89119-5263 - Phone
- (702) 732-1493
- Fax
- (702) 732-1080
- NPI assigned
- Aug 19, 2009
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1179 | NV | Primary |
Addresses
Primary practice location
1350 E Flamingo Rd
13B, Box 309
Las Vegas, NV 89119-5263
Mailing address
1090 E Desert Inn Rd
Suite 200
Las Vegas, NV 89109-2824
Phone (702) 732-1493
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
| License | State | Type | Specialty |
|---|---|---|---|
| PA1179 | NV | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250640000000",
"number": "1588896948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1090 E DESERT INN RD",
"address_2": "SUITE 200",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891092824",
"telephone_number": "702-732-1493",
"fax_number": "702-732-1080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 E FLAMINGO RD",
"address_2": "13B, BOX 309",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891195263",
"telephone_number": "702-732-1493",
"fax_number": "702-732-1080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOBBERTIN",
"first_name": "BRANDI",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-19",
"last_updated": "2009-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA1179",
"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 Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.