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GINA HEATHMON
Complete NPI Record 1235647686
Assistant Behavior Analyst in Las Vegas, NV

NPI Status: Active since January 19, 2018

Contact Information

3440 E RUSSELL RD # 212
LAS VEGAS, NV
ZIP 89120
Phone: (702) 712-3617
Fax: (702) 712-3617

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Business Practice Location Address Fax Number
  18. Provider Enumeration Date
  19. Last Update Date
  20. Provider Gender Code
  21. Healthcare Provider Taxonomy Code 1
  22. Healthcare Provider Primary Taxonomy Switch 1
  23. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1235647686. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1235647686
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).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: GINA
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Line Business Mailing Address: 3440 E RUSSELL RD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: LAS VEGAS
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Business Mailing Address State Name: NV
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address Postal Code: 891202201
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Telephone Number: 7022144212
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider First Line Business Practice Location Address: 3440 E RUSSELL RD # 212
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Practice Location Address City Name: LAS VEGAS
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Practice Location Address State Name: NV
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 Postal Code: 891202201
The city name in the location address of the provider being identified.
Provider Business Practice Location Address Country Code If outside U S : US
The State code in the location of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7027123617
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 7027123617
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 1/19/2018
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 1/19/2018
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 106E00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No