Active NPI
Miltia Alexa Marie Campbell III
- Rehabilitation Practitioner
- N Las Vegas, NV
National Provider Identifier
1679699458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 1505 John Bevy CT
N Las Vegas, NV 89086-1382 - Phone
- (330) 389-1250
- NPI assigned
- Mar 22, 2007
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 6701877 | OH | |
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
1505 John Bevy CT
N Las Vegas, NV 89086-1382
Mailing address
1505 John Bevy CT
N Las Vegas, NV 89086-1382
Phone (330) 389-1250
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396950374 | Medicaid | NV | |
| 2657478 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6701877 | OH | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1679699458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 JOHN BEVY CT",
"city": "N LAS VEGAS",
"state": "NV",
"postal_code": "890861382",
"telephone_number": "330-389-1250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 JOHN BEVY CT",
"city": "N LAS VEGAS",
"state": "NV",
"postal_code": "890861382",
"telephone_number": "330-389-1250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "MILTIA",
"middle_name": "ALEXA MARIE",
"name_prefix": "Mrs.",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": "6701877",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1396950374",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2657478",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in N 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 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.