Active NPI
Lindsey Ann Degruy
- Behavior Technician
- Las Vegas, NV
National Provider Identifier
1750867339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 480 South Jones Blvd
Las Vegas, NV 89107 - Phone
- (702) 502-8021
- Fax
- (888) 688-9464
- NPI assigned
- Jul 17, 2018
- 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 | Primary |
Addresses
Primary practice location
480 South Jones Blvd
Las Vegas, NV 89107
Mailing address
53 Fantasia LN
Henderson, NV 89074-3362
Phone (702) 423-1884
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": "1531785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531785600000",
"number": "1750867339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 FANTASIA LN",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890743362",
"telephone_number": "702-423-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 SOUTH JONES BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89107",
"telephone_number": "702-502-8021",
"fax_number": "888-688-9464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGRUY",
"first_name": "LINDSEY",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-17",
"last_updated": "2018-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"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 Jul 17, 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.