Active NPI
Justan Degeneffe
- Developmental - Behavioral Pediatrics Physician
- Las Vegas, NV
National Provider Identifier
1770132466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental - Behavioral Pediatrics Physician
- License
- 181456
- Practice address
- 7676 Silver Baron Rd
Las Vegas, NV 89179-2070 - Phone
- (702) 406-2325
- NPI assigned
- Sep 5, 2019
- Last updated
- May 18, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 181456 | NV | Primary |
Addresses
Primary practice location
7676 Silver Baron Rd
Las Vegas, NV 89179-2070
Mailing address
7676 Silver Baron Rd
Las Vegas, NV 89179-2070
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 |
|---|---|---|---|
| 181456 | NV | MD | Developmental - Behavioral Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779062400000",
"number": "1770132466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7676 SILVER BARON RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891792070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7676 SILVER BARON RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891792070",
"telephone_number": "702-406-2325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGENEFFE",
"first_name": "JUSTAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-05",
"last_updated": "2026-05-18",
"certification_date": "2026-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "NV",
"license": "181456",
"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 May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.