Individual provider Active NPI

Paris Jean Swift Eagle Johnson

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1821783986
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2106049731 Issued in NV
Practice address
4570 S Eastern Ave Ste 21
Las Vegas, NV 89119-6183
Phone
(702) 733-6033
NPI assigned
Apr 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NA NV
Pediatrics Physician 208000000X 2106049731 NV Primary

Addresses

Primary practice location

4570 S Eastern Ave Ste 21
Las Vegas, NV 89119-6183

Mailing address

4255 Tamarus St Apt 168
Las Vegas, NV 89119-5706
Phone (725) 256-3973

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
2106049731NVMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1821783986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 TAMARUS ST APT 168",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195706",
            "telephone_number": "725-256-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 S EASTERN AVE STE 21",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196183",
            "telephone_number": "702-733-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIFT EAGLE JOHNSON",
        "first_name": "PARIS",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "NA",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "2106049731",
            "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 5, 2023; 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.