Lakisha Rena Charles

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

3085 S Jones Blvd
Suite D
Las Vegas, NV 89146-6782

Phone

(702) 888-0036

Fax

(702) 888-0035

NPI assigned

Apr 11, 2016

Last updated

Apr 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mobile Mental Health Support Services, Inc.

  • Physical Disabilities Residential Treatment Facility
  • Las Vegas, NV
  • NPI 1871734772
  NPD (past)

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1841654340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271082",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891271082",
            "telephone_number": "702-573-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 S JONES BLVD",
            "address_2": "SUITE D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466782",
            "telephone_number": "702-888-0036",
            "fax_number": "702-888-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "LAKISHA",
        "middle_name": "RENA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joey Charles
• Jordan Christian Charles, CPC-INTERN
• Kamrykamell L Charles
• Kendra Charles
• Kori Charles
• Michel-Ange Charles
• Nichole Charles
• Tandalaya Charles
• Charleston Chua MD (Chua Plastic Surgery)
• Charleston Chua MD Medical Spa PLLC

• Rehabilitation Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Rehabilitation Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.