Organization Active NPI

Radiant Glow Wellness Center LLC

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1699665497
Registry record updated Jul 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
RADIANT GLOW WELLNESS CENTER LLC
Practice address
9816 Double Rock Dr
Las Vegas, NV 89134-6416
Phone
(702) 630-7655
NPI assigned
Jul 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2025

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

Authorized official

Name
Jennifer Spinato
Title
Owner
Phone
(702) 630-7655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

9816 Double Rock Dr
Las Vegas, NV 89134-6416

Mailing address

9816 Double Rock Dr
Las Vegas, NV 89134-6416

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1751587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751587200000",
    "number": "1699665497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9816 DOUBLE ROCK DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9816 DOUBLE ROCK DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346416",
            "telephone_number": "702-630-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT GLOW WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-04",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-03",
        "status": "A",
        "authorized_official_last_name": "SPINATO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-630-7655"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "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 Jul 4, 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.