Enobong Peter

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Practice address

3300 S Jones Blvd
Suite 102
Las Vegas, NV 89146-6787

Phone

(702) 452-0808

NPI assigned

Feb 19, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Destiny Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
  • NPI 1154557825
  NPD (past) Authorized official

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1629217310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S JONES BLVD",
            "address_2": "SUITE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466787",
            "telephone_number": "702-358-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 S JONES BLVD",
            "address_2": "SUITE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466787",
            "telephone_number": "702-452-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETER",
        "first_name": "ENOBONG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter G. Vajtai, M.D., LTD.
• Peter J Bregman, D.P.M. PLLC
• Peter Raymond Randall
• Peter Su MD LLC
• Cheyenne Alberta Peter, LPN
• Precious Peter
• Denise Michelle Peterkin
• Ahmad Peters
• Alexandar Joshua Peters, D.C.
• Amber Peters

• Durable Medical Equipment & Medical Supplies in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Durable Medical Equipment & Medical Supplies in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.

Verify at the official NPI Registry.