Individual provider Active NPI

Mariya Zhudeva

  • Pharmacy
  • North Las Vegas, NV
National Provider Identifier
1770062325
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
19957 Issued in NV
Practice address
6900 N Pecos Rd
North Las Vegas, NV 89086-4400
Phone
(702) 791-9000
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 19957 NV Primary

Addresses

Primary practice location

6900 N Pecos Rd
North Las Vegas, NV 89086-4400

Mailing address

3213 Bermuda Bay St
Las Vegas, NV 89117-5501

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

LicenseStateTypeSpecialty
19957NVMDPharmacy

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1770062325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 BERMUDA BAY ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 N PECOS RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890864400",
            "telephone_number": "702-791-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHUDEVA",
        "first_name": "MARIYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NV",
            "license": "19957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.

Verify at the official NPI Registry.