Active NPI
Fernan Peralta, LPN
- Addiction (Substance Use Disorder) Registered Nurse
- Las Vegas, NV
National Provider Identifier
1962913285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse
- License
- 16258
- Practice address
- 323 N Maryland Pkwy
Las Vegas, NV 89101-3130 - Phone
- (702) 385-3330
- NPI assigned
- Oct 13, 2017
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 16258 | NV | Primary |
Addresses
Primary practice location
323 N Maryland Pkwy
Las Vegas, NV 89101-3130
Mailing address
323 N Maryland Pkwy
Las Vegas, NV 89101-3130
Phone (702) 385-3330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPN16258 | Other | NV | LPN LICENSE |
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 |
|---|---|---|---|
| 16258 | NV | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507852800000",
"number": "1962913285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 N MARYLAND PKWY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891013130",
"telephone_number": "702-385-3330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 N MARYLAND PKWY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891013130",
"telephone_number": "702-385-3330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERALTA",
"first_name": "FERNAN",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-13",
"last_updated": "2017-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WA0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Addiction (Substance Use Disorder)",
"state": "NV",
"license": "16258",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPN LICENSE",
"identifier": "LPN16258",
"state": "NV"
}
],
"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 Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.