Individual provider Active NPI

Victor Enwedo, MHA

  • Student in an Organized Health Care Education/Training Program
  • North Las Vegas, NV
National Provider Identifier
1679464127
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4348 Sparkle Crest Ave
North Las Vegas, NV 89031-0434
Phone
(714) 458-7764
NPI assigned
Jul 14, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4348 Sparkle Crest Ave
North Las Vegas, NV 89031-0434

Mailing address

4348 Sparkle Crest Ave
North Las Vegas, NV 89031-0434
Phone (714) 458-7764

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

NPI Registry JSON

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1679464127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4348 SPARKLE CREST AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890310434",
            "telephone_number": "714-458-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 SPARKLE CREST AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890310434",
            "telephone_number": "714-458-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENWEDO",
        "first_name": "VICTOR",
        "credential": "MHA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North 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 14, 2025; 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.