DR. TRACY KODIYAN (NPI# 1881253300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881253300 |
| Entity Type | Individual |
| Full Name | DR. TRACY KODIYAN |
| Credential | M.D. |
| Practice Address |
5400 S Rainbow Blvd Las Vegas NV 89118-1859 |
| Mailing Address |
5155 S Torrey Pines Dr Apt 1015 Las Vegas NV 89118-0637 |
| Practice Telephone | 7028533000 |
| Enumeration Date | 2019-06-08 |
| Last Update Date | 2019-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 657 N Town Center Dr, Las Vegas, NV 891446367 | 7022337000 |
| Street Address |
5400 S RAINBOW BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89118-1859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346230323 | Spring Valley Medical Center | General Acute Care Hospital | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2005-10-21 |
| 1790397131 | Lauren Kristen Traver | Registered Nurse | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2020-08-18 |
| 1972121671 | Charisma Maria Rita Pagay | Nurse Practitioner | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2020-07-09 |
| 1114542073 | Zuzana Masarykova | Registered Nurse | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2020-06-16 |
| 1548898711 | Tony Ramogi | Student in an Organized Health Care Education/Training Program | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2020-04-01 |
| 1801423108 | Rubeena Dhami | Student in an Organized Health Care Education/Training Program | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2020-03-25 |
| 1578190880 | Tuong Van Thi Bui | Student in an Organized Health Care Education/Training Program | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2020-03-25 |
| 1295362804 | Bersabel Woldemariam | Student in an Organized Health Care Education/Training Program | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2020-03-24 |
| 1396372967 | Kevin Joseph Uson | Student in an Organized Health Care Education/Training Program | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2020-03-24 |
| 1750917696 | Kylie Henry | Physical Therapist | 5400 S Rainbow Blvd, Las Vegas, NV 89118-1859 | 2020-03-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720568520 | Kurt Yaross | Behavioral Analyst | 7138 W Post Rd, #208, Las Vegas, NV 89118 | 2018-08-21 |
| 1619457108 | Michelle Herzberg | Behavioral Analyst | 7318 W Post Rd #280, Las Vegas, NV 89118 | 2018-08-15 |
| 1548749385 | Keisha Bere-ruiz | Behavioral Analyst | 7318 W Post Rd #208, Las Vegas, NV 89118 | 2018-08-13 |
| 1295222081 | Aliantcare | Radiologic Technologist | 5490 S Rainbow Blvd, Suite 400 N34835, Las Vegas, NV 89118 | 2018-04-17 |
| 1710406467 | Anoush H. Tacvorian Do LLC | Clinic/Center | 6525 W. Warm Springs Rd, Suite 100, Las Vegas, NV 89118 | 2017-09-13 |
| 1962920470 | Harvard Medtech, LLC | Durable Medical Equipment & Medical Supplies | 6280 S. Valley View Blvd, Suite 412, Las Vegas, NV 89118 | 2017-09-05 |
| 1750827903 | Kerry Cutler | Nurse Practitioner | 6020 South Rainbow Blvd, Suite C, Las Vegas, NV 89118 | 2017-01-12 |
| 1184173015 | Girisgen & Kopolow Od PC | Optometrist | 7090 S Rainbow Blvd, Ste 100, Las Veegas, NV 89118 | 2016-10-04 |
| 1396117859 | Foundation for Positively Kids | Clinic/Center | 3555 E Reno, Ste F, Las Vegas, NV 89118 | 2015-10-23 |
| 1720492663 | Kiet Michael Lam | Chiropractor | 5693 S. Jones Bvld, Ste 116, Las Vegas, NV 89118 | 2014-06-18 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851906440 | David Hernandez | Student in an Organized Health Care Education/Training Program | 1510 Grape Arbor Way, Las Vegas, NV 89142-0669 | 2020-09-10 |
| 1710591110 | Jessica Celestino | Student in an Organized Health Care Education/Training Program | 6167 Allen Cove Ct, Las Vegas, NV 89148-1799 | 2020-09-02 |
| 1972127314 | Toyokazu Endo | Student in an Organized Health Care Education/Training Program | 2040 W Charleston Blvd Fl 3, Las Vegas, NV 89102-2227 | 2020-06-01 |
| 1962025775 | William Taylor Gravley | Student in an Organized Health Care Education/Training Program | 1510 Ruby Cliffs Ln Unit 204, Las Vegas, NV 89144-7015 | 2020-05-27 |
| 1477174449 | Vishnu Halthore | Student in an Organized Health Care Education/Training Program | 2152 Turquoise Ridge St Unit 205, Las Vegas, NV 89117-5972 | 2020-05-01 |
| 1417576869 | Jesus Mendez Jr. | Student in an Organized Health Care Education/Training Program | 10962 Pentland Downs St, Las Vegas, NV 89141-3997 | 2020-04-15 |
| 1124657333 | Daniel Gerardo Arias | Student in an Organized Health Care Education/Training Program | 700 Shadow Ln Ste 400, Las Vegas, NV 89106-4159 | 2020-04-08 |
| 1659900959 | Connor Wayman | Student in an Organized Health Care Education/Training Program | 6655 S Cimarron Rd, Las Vegas, NV 89113-2180 | 2020-04-07 |
| 1700413887 | Sameera Baig | Student in an Organized Health Care Education/Training Program | 2880 N. Tenaya Way, Las Vegas, NV 89128-0431 | 2020-03-26 |
| 1457988537 | Wesley Washington Yim | Student in an Organized Health Care Education/Training Program | 657 N Town Center Dr Ofc, Las Vegas, NV 89144-6367 | 2020-03-26 |
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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.