Active NPI
Shanetta Patterson
- Behavior Analyst
- Las Vegas, NV
National Provider Identifier
1780170639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 5412 Boulder Hwy
Las Vegas, NV 89122-6039 - Phone
- (702) 291-7121
- NPI assigned
- Jul 3, 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 Analyst | 103K00000X | Primary |
Addresses
Primary practice location
5412 Boulder Hwy
Las Vegas, NV 89122-6039
Mailing address
4791 E Craig Rd Unit C
Las Vegas, NV 89115-2576
Phone (702) 526-7959
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": "1530576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1780170639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4791 E CRAIG RD UNIT C",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891152576",
"telephone_number": "702-526-7959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5412 BOULDER HWY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891226039",
"telephone_number": "702-291-7121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "SHANETTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-03",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"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 Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.