NPIMap

Individual provider Active NPI

Tammy Lynn Green, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1013361435
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002197 Issued in NV
Practice address
2901 N Tenaya Way
Suite 210
Las Vegas, NV 89128-1420
Phone
(702) 255-0500
Fax
(702) 821-1704
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN002197 NV Primary

Addresses

Primary practice location

2901 N Tenaya Way
Suite 210
Las Vegas, NV 89128-1420

Mailing address

3640 Wedo Way
North Las Vegas, NV 89031-2281
Phone (702) 235-3488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405002111 NV Practitioner - Nurse Practitioner 6002192028 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Medical Center of Southern NevadaGroup PAC ID 7315934429, 388 clinicians
Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

5785 Centennial Ctr Blvd
Suite 190
Las Vegas, NV 89149-7110
Phone (702) 383-6270

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (954) 939-5000

Hospital & facility affiliations

  • University Medical Center Hospital, Las Vegas, NV, CCN 290007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN002197NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Center of Southern Nevada CurrentSince Oct 2, 2024 Accepting new patients
Shadow Emergency Physicians PLLC CurrentSince Mar 15, 2017 Accepting new patients
Yang Medical Services, PLLC CurrentSince Dec 3, 2020 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Oct 2, 2024 Accepting new patients
Shadow Emergency Physicians PLLC CurrentSince Mar 15, 2017 Accepting new patients

Locations

1050 W Galleria Dr
Henderson, NV 89011
Phone (702) 723-4124

1181 Grier Dr
Ste C
Las Vegas, NV 89119
Phone (888) 888-9930

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

5785 Centennial Center Blvd
Ste 190
Las Vegas, NV 89149
Phone (702) 383-6270

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1013361435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 WEDO WAY",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890312281",
            "telephone_number": "702-235-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N TENAYA WAY",
            "address_2": "SUITE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281420",
            "telephone_number": "702-255-0500",
            "fax_number": "702-821-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TAMMY",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.