NPIMap

Individual provider Active NPI

Jason Brende Ware, B.A. SOCIOLOGY

  • Rehabilitation Psychologist
  • Las Vegas, NV
National Provider Identifier
1669773420
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
Practice address
4660 S Eastern Ave
202
Las Vegas, NV 89119-6137
Phone
(702) 451-7542
Fax
(702) 450-4239
NPI assigned
Nov 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Psychologist 103TR0400X Primary

Addresses

Primary practice location

4660 S Eastern Ave
202
Las Vegas, NV 89119-6137

Mailing address

4660 S Eastern Ave
104A
Las Vegas, NV 89119-6137
Phone (702) 451-7542

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
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Bilingual Behavioral Services Past Accepting new patients
Mente Sana Education Provention 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1669773420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 S EASTERN AVE",
            "address_2": "104A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196137",
            "telephone_number": "702-451-7542",
            "fax_number": "702-450-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S EASTERN AVE",
            "address_2": "202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196137",
            "telephone_number": "702-451-7542",
            "fax_number": "702-450-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARE",
        "first_name": "JASON",
        "middle_name": "BRENDE",
        "credential": "B.A. SOCIOLOGY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "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 Nov 10, 2010; 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.