ANGELA NAOMI LYBBERT (NPI# 1801907621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801907621 |
| Entity Type | Individual |
| Full Name | ANGELA NAOMI LYBBERT |
| Credential | PA-C |
| Practice Address |
4270 S Decatur Blvd Ste B5 Las Vegas NV 89103-6802 |
| Mailing Address |
9325 Ram Cliffs Pl Las Vegas NV 89178-3533 |
| Practice Telephone | 7252204200 |
| Practice Fax Number | 7252204199 |
| Mailing Telephone | 7022789135 |
| Mailing Fax Number | 8883845951 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-05-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA685 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 100510051 | 05 | |
| NV | ANTHEM BCBS NV GROUP | NV1360 | 01 |
| NV | 002402137 | 05 | |
| NV | ANTHEM BCBS NV | CC9894 | 01 |
| NV | NV MEDICARE PTAN | V103699 | 01 |
| Street Address |
4270 S DECATUR BLVD STE B5 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89103-6802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023570090 | Jan Michael Vincent Galang Diaz | Nurse Practitioner | 4270 S Decatur Blvd Ste B5, Las Vegas, NV 89103-6802 | 2019-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043821671 | New Directions LLC | Counselor | 3651 S Lindell Dr, Ste D15 B, Las Vegas, NV 89103 | 2020-08-17 |
| 1396356929 | A-plus Community Counseling Services LLC | Counselor | 3651 S Lindell Dr Ste D15, Las Vegas, NV 89103 | 2020-08-17 |
| 1437798931 | Las Vegas Diagnostic & Treatment LLC | Neuromusculoskeletal Medicine & OMM | Dpm, 5650 W Flamingo Rd Ste A, Las Vegas, NV 89103 | 2019-12-31 |
| 1033769385 | Maria Yemi Centeno | Technician | 4674 Via Torino, Las Vegas, NV 89103 | 2019-09-18 |
| 1750847869 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3821 W Flamingo Rd, Las Vegas, NV 89103 | 2019-02-13 |
| 1447741905 | Adgold Medical Corp | Durable Medical Equipment & Medical Supplies | 3651 Lindell Rd Ste D536, Las Vegas, NV 89103 | 2018-05-21 |
| 1184138620 | Kiley Ballew | Social Worker | 4425 South Jones, Suite D3, Las Vegas, NV 89103 | 2017-11-20 |
| 1396275988 | Karen Walton | Technician | 5419 W. Tropicana Ave. A2803, Las Vegas, NV 89103 | 2017-06-15 |
| 1760923643 | Shannon-dorothy Austria | Social Worker | 4425 S. Jones, Suite D3, Las Vegas, NV 89103 | 2017-03-13 |
| 1306260583 | Ladonna Smith | Behavioral Analyst | 1126 Tamerck Ave, Las Vegas, NV 89103 | 2014-02-10 |
| Find all providers in zip 89103 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821554106 | Amy Hamilton | Physician Assistant | 5785 Centennial Center Blvd Ste 190, Las Vegas, NV 89149-7110 | 2019-02-12 |
| 1386145159 | Kevin Refahiyat | Physician Assistant | 7150 S Durango Dr Ste 105, Las Vegas, NV 89113-2242 | 2018-02-26 |
| 1316487325 | Nadiya-larissa Bateman | Physician Assistant | 2809 W Charleston Blvd # 150, Las Vegas, NV 89102-1998 | 2017-02-24 |
| 1760840797 | Ying Quan | Physician Assistant | 2995 S Jones Blvd Ste A, Las Vegas, NV 89146-5612 | 2016-02-04 |
| 1396121646 | Lucas Michal Anderson | Physician Assistant | 9050 W Tropicana Ave, 1159, Las Vegas, NV 89147-8186 | 2015-08-09 |
| 1851631378 | Matthew Sanders | Physician Assistant | 6870 S. Rainbow Blvd, Suite 106, Las Vegas, NV 89118 | 2013-02-20 |
| 1285973289 | Jesus Angel Corn Sotelo | Physician Assistant | 4225 S Eastern Ave Ste 8, Las Vegas, NV 89119-5485 | 2013-02-11 |
| 1952675993 | Donald Patrick Mcgrorey Md Pllc | Physician Assistant | 6440 N Durango Dr Bldg A, Las Vegas, NV 89149-8513 | 2012-03-07 |
| 1508136375 | Leigh Richards Boeckle | Physician Assistant | 9033 W Sahara Ave, Las Vegas, NV 89117 | 2012-01-10 |
| 1225315229 | Samantha J Van Ginneken | Physician Assistant | 8020 S Rainbow Blvd Ste 100, Box #536, Las Vegas, NV 89139-6494 | 2011-11-04 |
| 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.