Active NPI
Johnny Guadalupe Bueno
- Personal Care Attendant
- Las Vegas, NV
National Provider Identifier
1609375179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 1951 Stella Lake St
Las Vegas, NV 89106-2114 - Phone
- (702) 595-8309
- NPI assigned
- Feb 9, 2018
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
1951 Stella Lake St
Las Vegas, NV 89106-2114
Mailing address
3024 Arrowhead St
North Las Vegas, NV 89030-5029
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2100815814 | Medicaid | NV |
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": "1518134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518134400000",
"number": "1609375179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3024 ARROWHEAD ST",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890305029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1951 STELLA LAKE ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891062114",
"telephone_number": "702-595-8309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUENO",
"first_name": "JOHNNY",
"middle_name": "GUADALUPE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-02-09",
"last_updated": "2018-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2100815814",
"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 Feb 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.