FIDEL PETERSON (NPI# 1720699812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720699812 |
| Entity Type | Individual |
| Full Name | FIDEL PETERSON |
| Practice Address |
8670 W Cheyenne Ave Ste 135 Las Vegas NV 89129-7460 |
| Practice Telephone | 7028222600 |
| Mailing Telephone | 7028222600 |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| Street Address |
8670 W CHEYENNE AVE STE 135 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89129-7460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669969002 | Tracey L Richards | Technician | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2018-04-20 |
| 1316547235 | Bryanne Dennis-eason | Home Health Aide | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2020-10-29 |
| 1114527405 | Nordica Goldsmith | Home Health Aide | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2020-10-27 |
| 1982204418 | Howard Gardner | Home Health Aide | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2020-10-26 |
| 1912505298 | Ada Johnson | Home Health Aide | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2020-10-09 |
| 1710590104 | Cheryl Hilliard | Technician | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2020-08-26 |
| 1245842970 | Martina Cade | Technician | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2020-08-24 |
| 1427669514 | Kyanesha Richardson Mccall | Technician | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2020-08-12 |
| 1669081410 | Audrey Matthews | Technician | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2020-07-28 |
| 1548879216 | Jacqueline Lester | Technician | 8670 W Cheyenne Ave Ste 135, Las Vegas, NV 89129-7460 | 2020-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699387621 | Voice Specialist LLC | Speech-Language Pathologist | 3701 Paul Deweert Ct, Las Vegas, NV 89129 | 2020-08-20 |
| 1215563358 | Aba Homecare LLC | In Home Supportive Care | 4456 N Prospect Hill Ct, Las Vegas, NV 89129 | 2020-03-20 |
| 1568935534 | Las Vegas Family Medicine Inc. | Family Medicine | 7660 W. Cheyenne Ave Suite 110, Las Vegas, NV 89129 | 2019-01-02 |
| 1477040798 | Cynthia Beverly Springer | Technician | 8670 West Cheyenne Suite 135, Las Vegas, NV 89129 | 2018-04-23 |
| 1518471093 | 3 Pharmacy LLC | Pharmacy | 3350 Novat St Ste 110, Las Vegas, NV 89129 | 2017-11-20 |
| 1497207393 | Morgan A Lavergne | Behavioral Analyst | 7650 Siesta Grande Ave., Las Vegas, NV 89129 | 2016-10-27 |
| 1255880191 | Sierra Treatment and Recovery Services, LLC | Clinic/Center | 3321 N. Buffalo Dr., Suite #125, Las Vegas, NV 89129 | 2016-10-03 |
| 1710433545 | Tyson Miller | Dentist | 3600 N Buffalo Dr., #110, Las Vegas, NV 89129 | 2016-08-31 |
| 1427450923 | Jerale Tiffith | Behavioral Analyst | 3800 Dalecrest Dr., 2801, Las Vegas, NV 89129 | 2014-09-16 |
| 1134463821 | Paul Carr | Behavioral Analyst | 4460 Park Ave, Las Vegas, NV 89129 | 2012-11-19 |
| Find all providers in zip 89129 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396628 | Jill Azevedo | Technician | 6300 Black Mesa Ct, Las Vegas, NV 89142-7919 | 2020-11-06 |
| 1396346409 | Johanna Dwyer | Technician | 5755 E Lake Mead Blvd Apt D, Las Vegas, NV 89156-6859 | 2020-11-04 |
| 1063013274 | Lloyd Major | Technician | 3830 University Center Dr Apt 318, Las Vegas, NV 89119-7420 | 2020-11-04 |
| 1861093239 | Raiquave Morgan | Technician | 5256 Tamarus St Apt B, Las Vegas, NV 89119-5047 | 2020-11-03 |
| 1669073250 | Chrissy Bowser | Technician | 3355 Spg Mnt Rd Ste 67, Las Vegas, NV 89102-8633 | 2020-11-02 |
| 1235739392 | Maxima Del Carmen Garcia | Technician | 3580 E Alexander Rd Apt 2016, Las Vegas, NV 89115 | 2020-10-28 |
| 1427657196 | Hector Querubin | Technician | 5400 S Maryland Pkwy Apt 165, Las Vegas, NV 89119-2642 | 2020-10-22 |
| 1043819063 | Ma Guadalupe Ramos Michel | Technician | 2415 Reynolds Ave #101, Las Vegas, NV 89030 | 2020-10-21 |
| 1881293777 | Miguel Angel Umpierre | Technician | 9889 Overlook Ridge Ave, Las Vegas, NV 89148 | 2020-10-21 |
| 1356940654 | Shannon Gordon | Technician | 1224 W Lake Mead Blvd, Las Vegas, NV 89106-2415 | 2020-10-19 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.