Individual provider Active NPI

Eliscia Wight, PHARMD

  • Pharmacist
  • Henderson, NV
National Provider Identifier
1689959272
Registry record updated Oct 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17013 Issued in NV
Practice address
101 E. Lake Mead Pkwy
Henderson, NV 89005
Phone
(702) 566-9706
NPI assigned
Oct 15, 2011
Last updated
Oct 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17013 NV Primary

Addresses

Primary practice location

101 E. Lake Mead Pkwy
Henderson, NV 89005

Mailing address

9049 Pine Mission Ave
Las Vegas, NV 89143-1124
Phone (702) 370-0287

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
17013NVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1318636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318636800000",
    "number": "1689959272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9049 PINE MISSION AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891431124",
            "telephone_number": "702-370-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E. LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89005",
            "telephone_number": "702-566-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGHT",
        "first_name": "ELISCIA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-15",
        "last_updated": "2011-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "17013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.

Verify at the official NPI Registry.