JACKSON PSYCHIATRIC AND PRIMARY CARE SERVICES LLC
Nurse Practitioner (Family)

Address: 9005 W Oquendo Rd Apt 3036, Las Vegas, NV 89148-1524

JACKSON PSYCHIATRIC AND PRIMARY CARE SERVICES LLC (NPI# 1689251183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689251183
Entity Type Organization
Organization Name JACKSON PSYCHIATRIC AND PRIMARY CARE SERVICES LLC
Practice Address 9005 W Oquendo Rd Apt 3036
Las Vegas
NV 89148-1524
Practice Telephone 9012831975
Mailing Address 9005 W Oquendo Rd Apt 3036
Las Vegas
NV 89148-1524
Mailing Telephone 9012831975
Certification Date 2021-04-12
Enumeration Date 2021-03-29
Last Update Date 2021-04-12
Authorized Official Telephone 9012831975
Authorized Official Credential NP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
N 363LF0000X Nurse Practitioner
Specialization: Family
193400000X MULTIPLE SINGLE SPECIALTY GROUP Physician Assistants & Advanced Practice Nursing Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
193400000X SINGLE SPECIALTY GROUP Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 9005 W OQUENDO RD APT 3036
City LAS VEGAS
State NV
Zip Code 89148-1524

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NPI Name Taxonomy Address Enumeration
1154912301 Samantha Lee Nurse Practitioner 3186 South Maryland Parkway, Las Vegas, NV 89148 2021-01-31
1881293777 Miguel Angel Umpierre Technician - Personal Care Attendant 9889 Overlook Ridge Ave, Las Vegas, NV 89148 2020-10-21
1689280588 Santos Nunez Technician - Personal Care Attendant 7950 Mcginnis Ave, Las Vegas, NV 89148 2020-09-17
1861007734 Daniel D Forro Occupational Therapist 10164 Phelps Lake Ct, Las Vegas, NV 89148 2020-09-08
1568098309 Moinca R Ponce Dentist - Oral and Maxillofacial Surgery 9450 West Russell Rd, Suite #103, Las Vegas, NV 89148 2020-03-12
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1720621865 Building Hope Nevada Community/Behavioral Health 8936 Spanish Ridge, Las Vegas, NV 89148 2019-10-22
1790343721 Maretes Godinez Case Manager/Care Coordinator 6070 S Fort Apache Rd., Suite 110, Las Vegas, NV 89148 2019-06-04
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1255911418 Shautauqua Blocker Nurse Practitioner - Psych/Mental Health 3700 S Maryland Pkwy # 525d, Las Vegas, NV 89119-5615 2021-04-12
1245823863 Reimund Serafica Nurse Practitioner - Psych/Mental Health 3000 W Charleston Blvd Ste 5, Las Vegas, NV 89102-1940 2021-02-15
1366033342 Mary Grace Almirante Del Rosario Nurse Practitioner - Psych/Mental Health 5973 Atlantis Dream Ave, Las Vegas, NV 89139-6978 2021-02-01
1992396998 Susan Candelaria Nurse Practitioner - Psych/Mental Health 911 N Buffalo Dr # 206213, Las Vegas, NV 89128-0379 2021-02-01
1821687427 Brian Elliot Meyer Nurse Practitioner - Psych/Mental Health 9110 W Tropicana Ave Unit 162, Las Vegas, NV 89147-8152 2021-01-18
1740883958 Mile High Psychiatry LLC Nurse Practitioner - Psych/Mental Health 848 N Rainbow Blvd # 228, Las Vegas, NV 89107-1103 2020-11-19
1093315236 Steven Jon Knott Nurse Practitioner - Psych/Mental Health 2675 S Jones Blvd Ste 102, Las Vegas, NV 89146-5607 2020-10-27
1730792219 Mercedes Ocan Nurse Practitioner - Psych/Mental Health 4000 S Eastern Ave Ste 125, Las Vegas, NV 89119-0814 2020-08-25
1205447406 Shaheen Waqar Ahmad Nurse Practitioner - Psych/Mental Health 4270 S Decatur Blvd, Las Vegas, NV 89103-6800 2020-08-11
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City LAS VEGAS
Zip Code 89148

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Dataset Information

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.

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