Individual provider Active NPI

Jill Flynn

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1023186905
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW1218C Issued in NV
Practice address
7375 Prairie Falcon Rd Ste 160
Las Vegas, NV 89128-0818
Phone
(702) 233-3000
Fax
(702) 256-1310
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW1218C NV Primary

Addresses

Primary practice location

7375 Prairie Falcon Rd Ste 160
Las Vegas, NV 89128-0818

Mailing address

7375 Prairie Falcon #160
Las Vegas, NV 89128-3310
Phone (702) 233-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW1218CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023186905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7375 PRAIRIE FALCON #160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891283310",
            "telephone_number": "702-233-3000",
            "fax_number": "702-256-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7375 PRAIRIE FALCON RD STE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280818",
            "telephone_number": "702-233-3000",
            "fax_number": "702-256-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "JILL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "CSW1218C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.