Individual provider Active NPI

Yandry Rodriguez Hernandez

  • Technician
  • Las Vegas, NV
National Provider Identifier
1679181796
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
Practice address
4535 W Russell Rd Ste 15
Las Vegas, NV 89118-2258
Phone
(702) 368-2380
NPI assigned
Jul 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X Primary

Addresses

Primary practice location

4535 W Russell Rd Ste 15
Las Vegas, NV 89118-2258

Mailing address

3145 Avondale Ave
Las Vegas, NV 89121-2601
Phone (702) 748-5679

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

OrganizationSpecialtyStatusNew patients
The Center for Change LLC CurrentSince Jul 27, 2020 Accepting new patients
The Center for Change LLC CurrentSince May 9, 2021 Accepting new patients

Locations

4535 W Russell Rd
Ste 15
Las Vegas, NV 89118
Phone (702) 368-2380

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": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1679181796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 AVONDALE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891212601",
            "telephone_number": "702-748-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 W RUSSELL RD STE 15",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182258",
            "telephone_number": "702-368-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ HERNANDEZ",
        "first_name": "YANDRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "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 15, 2020; 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.