Wendy Chisholm, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1184 Issued in NV

Practice address

888 S Rancho Dr
Urgent Care
Las Vegas, NV 89106-3810

Phone

(702) 877-8600

Fax

(702) 258-6152

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NV, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment
• San Francisco Physicians International Medical Group, Inc

  • Emergency Medicine Physician
  • San Ramon, CA
  • NPI 1841220720
  Medicare reassignment
• Team Physicians of California Medical Group Inc

  • Emergency Medicine Physician
  • Delano, CA
  • NPI 1447288345
  Medicare reassignment
• Linda L. Johnson MD, LTD

  • Adult Medicine Physician
  • Henderson, NV
  • NPI 1376838110
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1700930302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-838-8265",
            "fax_number": "702-804-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S RANCHO DR",
            "address_2": "URGENT CARE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063810",
            "telephone_number": "702-877-8600",
            "fax_number": "702-258-6152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "WENDY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700930302",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00915410",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chisal Enterprises, Inc.
• Natalie Chisam
• Shan Chisam
• Wanda Jean Chiscolm, COTA/L
• Crystal Chisholm
• Latazia Leona Chism
• Regina Chismer
• Guy Landry Tatsuo Chisteckoff, D.D.S.
• Chit Chat Speech Therapy
• Daniel Chiti, PHARMD

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.