Nicholas Paul Pituk, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0506190 Issued in NV

Practice address

6425 S Jones Blvd Ste 102
Las Vegas, NV 89118-3303

Phone

(703) 405-9106

NPI assigned

Nov 22, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1689278533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 CANOSA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891042827",
            "telephone_number": "703-405-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 S JONES BLVD STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183303",
            "telephone_number": "703-405-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITUK",
        "first_name": "NICHOLAS",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-22",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NV",
            "license": "0506190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Demetra Pitts
• Monica Pitts
• Quentin Forrest Pitts, PT
• Rebecca L Pitts, MSN, FPMHNP
• Tamara Lynn Pitts
• Jessalyn Pitz
• Autasia Piula
• Pivot Behavioral Health Services
• Pivot Behavioral Health Services LLC
• Filomena Pixler

• Athletic Trainer in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Athletic Trainer in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.