Individual provider Active NPI

Maria Lynna Tambanillo Canindo, RN

  • Registered Nurse
  • Las Vegas, NV
National Provider Identifier
1750671970
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
63154 Issued in IL
Practice address
8880 W Sunset Rd Ste 190
Las Vegas, NV 89148-5005
Phone
(702) 893-3333
Fax
(702) 893-0960
NPI assigned
Apr 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 63154 IL Primary

Addresses

Primary practice location

8880 W Sunset Rd Ste 190
Las Vegas, NV 89148-5005

Mailing address

8880 W Sunset Rd Ste 190
Las Vegas, NV 89148-5005
Phone (702) 893-3333

Other identifiers 1

IdentifierTypeStateIssuer
001702161MedicaidNV

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
63154ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
GS Integrated Healthcare Systems, LLC. 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": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1750671970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8880 W SUNSET RD STE 190",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485005",
            "telephone_number": "702-893-3333",
            "fax_number": "702-893-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 W SUNSET RD STE 190",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485005",
            "telephone_number": "702-893-3333",
            "fax_number": "702-893-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANINDO",
        "first_name": "MARIA LYNNA",
        "middle_name": "TAMBANILLO",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-08",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "63154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001702161",
            "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 Apr 8, 2011; 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.