Active NPI
Gabriella Marie Nellis, RBT
- Behavior Technician
- Las Vegas, NV
National Provider Identifier
1730565375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-15-05675
- Practice address
- 630 S Rancho Dr Ste a
Las Vegas, NV 89106-4849 - Phone
- (702) 998-9505
- Fax
- (702) 527-7939
- NPI assigned
- Aug 5, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-15-05675 | NV | Primary |
Addresses
Primary practice location
630 S Rancho Dr Ste a
Las Vegas, NV 89106-4849
Mailing address
57 W 1124 N Apt 1
Logan, UT 84341-6851
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730565375 | Medicaid | NV | |
| RBT-15-05675 | Other | NV | BEHAVIOR TECHNICIAN REGISTRY |
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 |
|---|---|---|---|
| RBT-15-05675 | NV | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518652800000",
"number": "1730565375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 W 1124 N APT 1",
"city": "LOGAN",
"state": "UT",
"postal_code": "843416851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 S RANCHO DR STE A",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064849",
"telephone_number": "702-998-9505",
"fax_number": "702-527-7939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELLIS",
"first_name": "GABRIELLA",
"middle_name": "MARIE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-05",
"last_updated": "2018-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NV",
"license": "RBT-15-05675",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1730565375",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR TECHNICIAN REGISTRY",
"identifier": "RBT-15-05675",
"state": "NV"
}
],
"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 Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.