Active NPI
John Adams Evangelista Perez, LMSW
- Social Worker
- Las Vegas, NV
National Provider Identifier
1700610649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 12608-M
- Practice address
- 3551 E Bonanza Rd
Las Vegas, NV 89110-0055 - Phone
- (702) 608-1488
- NPI assigned
- Aug 30, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | NV | ||
| Social Worker | 104100000X | 12608-M | NV | Primary |
Addresses
Primary practice location
3551 E Bonanza Rd
Las Vegas, NV 89110-0055
Mailing address
3551 E Bonanza Rd
Las Vegas, NV 89110-0055
Phone (702) 608-1488
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 |
|---|---|---|---|
| 12608-M | NV | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FDV Wellness Center | Rehabilitation Practitioner | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757894400000",
"number": "1700610649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 E BONANZA RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891100055",
"telephone_number": "702-608-1488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 E BONANZA RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891100055",
"telephone_number": "702-608-1488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "JOHN ADAMS",
"middle_name": "EVANGELISTA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-30",
"last_updated": "2025-09-15",
"certification_date": "2025-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NV",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NV",
"license": "12608-M",
"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 Sep 15, 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.