NPI 1144714296 · live from the CMS NPI Registry
Jeremy Anderson, DPM
Podiatrist in Las Vegas, NV. National Provider Identifier 1144714296, active.
NPI record
| NPI | 1144714296 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 1416 S Jones Blvd, Las Vegas, NV 89146 |
| Practice phone | 702-878-1400 |
| Mailing address | 500 Foothill Dr, Slc, UT 84148 |
| Enumerated | June 20, 2018 |
| Last updated | August 3, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | 11354714-0501 (UT) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — (UT) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Podiatrist primary | 213E00000X | 2077 (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.