Active NPI
Tara Monique Wilson
- Personal Care Attendant
- Las Vegas, NV
National Provider Identifier
1629641444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 1055 E Flamingo Rd
Las Vegas, NV 89119-7441 - Phone
- (702) 955-0267
- NPI assigned
- Jul 20, 2021
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
1055 E Flamingo Rd
Las Vegas, NV 89119-7441
Mailing address
1055 E Flamingo Rd
Las Vegas, NV 89119-7441
Phone (702) 955-0267
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| At Peace Inc. | Home Health Aide | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1629641444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 E FLAMINGO RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891197441",
"telephone_number": "702-955-0267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 E FLAMINGO RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891197441",
"telephone_number": "702-955-0267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TARA",
"middle_name": "MONIQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-20",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"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 Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.