Active NPI
Crystal A Phelps, N/A
- Student in an Organized Health Care Education/Training Program
- Las Vegas, NV
National Provider Identifier
1932457504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 7673753
- Practice address
- 2165 E Rochelle Ave # 58
Las Vegas, NV 89119 - Phone
- (702) 612-2707
- NPI assigned
- Aug 29, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 7673753 | OR | Primary |
Addresses
Primary practice location
2165 E Rochelle Ave # 58
Las Vegas, NV 89119
Mailing address
2165 E Rochelle Ave # 58
Las Vegas, NV 89119
Phone (702) 612-2707
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 |
|---|---|---|---|
| 7673753 | OR | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1932457504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2165 E ROCHELLE AVE # 58",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89119",
"telephone_number": "702-612-2707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2165 E ROCHELLE AVE # 58",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89119",
"telephone_number": "702-612-2707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELPS",
"first_name": "CRYSTAL",
"middle_name": "A",
"credential": "N/A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OR",
"license": "7673753",
"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 Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.