Active NPI
Somsavai Keodara Liston, RPH
- Pharmacist
- Las Vegas, NV
National Provider Identifier
1659654903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15771
- Practice address
- 6825 N Durango Dr
Las Vegas, NV 89149-4594 - Phone
- (702) 260-8242
- Fax
- (702) 260-7225
- NPI assigned
- Sep 23, 2011
- Last updated
- Sep 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15771 | NV | Primary |
| Pharmacist | 183500000X | 54056 | CA |
Addresses
Primary practice location
6825 N Durango Dr
Las Vegas, NV 89149-4594
Mailing address
6574 Fence Jumper Ave
Las Vegas, NV 89131-0222
Phone (702) 396-0394
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15771 | NV | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316736000000",
"number": "1659654903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6574 FENCE JUMPER AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891310222",
"telephone_number": "702-396-0394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6825 N DURANGO DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891494594",
"telephone_number": "702-260-8242",
"fax_number": "702-260-7225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISTON",
"first_name": "SOMSAVAI",
"middle_name": "KEODARA",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-23",
"last_updated": "2011-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "15771",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "54056",
"primary": false
}
],
"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 Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.