Individual provider Active NPI

Samantha Rae Sioson Go, LPN

  • Licensed Practical Nurse
  • Las Vegas, NV
National Provider Identifier
1992575286
Registry record updated Feb 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
859371 Issued in NV
Practice address
2950 E Flamingo Rd Ste JB
Las Vegas, NV 89121-5209
Phone
(818) 857-1393
NPI assigned
Jan 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 859371 NV Primary

Addresses

Primary practice location

2950 E Flamingo Rd Ste JB
Las Vegas, NV 89121-5209

Mailing address

3015 Moulin Heights St
Las Vegas, NV 89156-3791
Phone (818) 857-1393

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

LicenseStateTypeSpecialty
859371NVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708128000000",
    "number": "1992575286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 MOULIN HEIGHTS ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891563791",
            "telephone_number": "818-857-1393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 E FLAMINGO RD STE JB",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215209",
            "telephone_number": "818-857-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GO",
        "first_name": "SAMANTHA RAE",
        "middle_name": "SIOSON",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-02-17",
        "certification_date": "2024-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NV",
            "license": "859371",
            "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 Feb 17, 2024; 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.