Individual provider Active NPI

Bianca Vaudreuil

  • Religious Nonmedical Practitioner
  • Las Vegas, NV
National Provider Identifier
1922629765
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Religious Nonmedical PractitionerTaxonomy code 374K00000X
Practice address
3210 W Charleston Ste 2
Las Vegas, NV 89102
Phone
(702) 893-2001
NPI assigned
May 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Religious Nonmedical Practitioner 374K00000X Primary

Addresses

Primary practice location

3210 W Charleston Ste 2
Las Vegas, NV 89102

Mailing address

3210 W Charleston Ste 2
Las Vegas, NV 89102
Phone (702) 893-2001

Other identifiers 1

IdentifierTypeStateIssuer
1111111111MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL clear

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": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1922629765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 W CHARLESTON STE 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89102",
            "telephone_number": "702-893-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 W CHARLESTON STE 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89102",
            "telephone_number": "702-893-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUDREUIL",
        "first_name": "BIANCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1111111111",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "clear",
            "affiliation": "N",
            "address_1": "3210 W CHARLESTON STE 2",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "89102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 May 4, 2020; 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.