NPI |
1538674734 |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
Entity Type Code |
1 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider Last Name Legal Name |
LOUIS |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider First Name |
TROY |
The first name of the provider, if the provider
is an individual. |
Provider First Line Business Practice Location Address |
4200 PARADISE RD |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address City Name |
LAS VEGAS |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
NV |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
891696548 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
7023347769 |
The State code in the location of the provider
being identified. |
Provider Enumeration Date |
12/11/2017 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Last Update Date |
12/11/2017 |
The country code in the location address of the provider being identified. |
Provider Gender Code |
M |
The telephone number associated with the location address of the provider being identified. |
Healthcare Provider Taxonomy Code 1 |
172V00000X |
The date the provider was assigned a unique identifier (assigned an NPI). |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
The date that a record was last updated or changed. |
Is Sole Proprietor |
N |
The code designating the provider’s gender if the provider is a person. |