Active NPI
Ty-Yivri Glover
- Behavior Analyst
- North Las Vegas, NV
National Provider Identifier
1922443910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 102617
- Practice address
- 4107 W Cheyenne Ave Ste 109
North Las Vegas, NV 89032-3476 - Phone
- (702) 574-5297
- Fax
- (702) 629-7952
- NPI assigned
- May 3, 2013
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 102617 | NV | Primary |
Addresses
Primary practice location
4107 W Cheyenne Ave Ste 109
North Las Vegas, NV 89032-3476
Mailing address
4107 W Cheyenne Ave Ste 109
North Las Vegas, NV 89032-3476
Phone (702) 574-5297
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 |
|---|---|---|---|
| 102617 | NV | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367539200000",
"number": "1922443910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4107 W CHEYENNE AVE STE 109",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890323476",
"telephone_number": "702-574-5297",
"fax_number": "702-629-7952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4107 W CHEYENNE AVE STE 109",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890323476",
"telephone_number": "702-574-5297",
"fax_number": "702-629-7952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOVER",
"first_name": "TY-YIVRI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-03",
"last_updated": "2013-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NV",
"license": "102617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North 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 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.