Active NPI
Willie Bawarski
- Pharmacist
- Las Vegas, NV
National Provider Identifier
1689959157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17952
- Practice address
- 4620 Dream Catcher Ave
Las Vegas, NV 89129-5354 - Phone
- (315) 527-9838
- NPI assigned
- Oct 17, 2011
- Last updated
- Oct 17, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17952 | NV | Primary |
Addresses
Primary practice location
4620 Dream Catcher Ave
Las Vegas, NV 89129-5354
Mailing address
900 N Rancho Dr
Las Vegas, NV 89106-1005
Phone (315) 527-9838
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 |
|---|---|---|---|
| 17952 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318809600000",
"number": "1689959157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 N RANCHO DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891061005",
"telephone_number": "315-527-9838",
"fax_number": "702-646-5987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4620 DREAM CATCHER AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891295354",
"telephone_number": "315-527-9838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAWARSKI",
"first_name": "WILLIE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-17",
"last_updated": "2011-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "17952",
"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 Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.