Individual provider Active NPI

Chassity Gulley

  • Health & Wellness Coach
  • Henderson, NV
National Provider Identifier
1710569710
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
Practice address
100 N Green Valley Pkwy Ste 235
Henderson, NV 89074-7704
Phone
(725) 333-8036
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X Primary

Addresses

Primary practice location

100 N Green Valley Pkwy Ste 235
Henderson, NV 89074-7704

Mailing address

10115 Jeffreys St Apt 2015
Las Vegas, NV 89183-7913
Phone (419) 708-6623

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

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1710569710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10115 JEFFREYS ST APT 2015",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837913",
            "telephone_number": "419-708-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY STE 235",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747704",
            "telephone_number": "725-333-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEY",
        "first_name": "CHASSITY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "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 Apr 28, 2021; 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.