Jude Niba

Primary specialty

Exercise & Sports PsychologistTaxonomy code 103TE1100X

License

667 Issued in NV

Practice address

9082 Vintage Wine Ave
Las Vegas, NV 89148

Phone

(170) 232-8045

NPI assigned

Apr 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community Youth Interalia

  • Exercise & Sports Psychologist
  • Las Vegas, NV
  • NPI 1790282002
  NPD (past) Authorized official
• Seao Interalia

  • Non-emergency Medical Transport (VAN)
  • Las Vegas, NV
  • NPI 1871055947
  NPD (past) Authorized official

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1821586512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9082 VINTAGE WINE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484916",
            "telephone_number": "170-232-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9082 VINTAGE WINE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89148",
            "telephone_number": "170-232-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIBA",
        "first_name": "JUDE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "NV",
            "license": "667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSOCIATION FOR APPLIED SPORT PSYCHOLOGY",
            "identifier": "667",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NHV Management Services LLC
• Jonathan Ni, DO
• Xiaomei Ni
• Zeping Ni
• Morsal Niazi
• Nibiru Medical Center LLC
• Desirie Nicasio
• Mary Nicastro
• Kiana Nicdao
• Maria Ana Nicdao

• Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.