Individual provider Active NPI

Brooke Minetto

  • Student in an Organized Health Care Education/Training Program
  • Las Vegas, NV
National Provider Identifier
1952071987
Registry record updated Mar 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
9260 W Sunset Rd Ste 110
Las Vegas, NV 89148-4903
Phone
(702) 916-6906
NPI assigned
Sep 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

9260 W Sunset Rd Ste 110
Las Vegas, NV 89148-4903

Mailing address

9260 W Sunset Rd Ste 110
Las Vegas, NV 89148-4903

Other practice location 1

874 American Pacific Dr
Henderson, NV 89014-8800
Phone (702) 777-8687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230926002457 NV Order and Referring Only - PsychiatryPractitioner - Psychiatry 9638523509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679097600000",
    "number": "1952071987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 W SUNSET RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9260 W SUNSET RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484903",
            "telephone_number": "702-916-6906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "874 American Pacific Dr",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890148800",
            "country_code": "US",
            "telephone_number": "702-777-8687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINETTO",
        "first_name": "BROOKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2023-03-18",
        "certification_date": "2023-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.