NPIMap

Individual provider Active NPI

Jeremey Dwayne Sturgill, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1053686311
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2495 Issued in NV
Practice address
3900 Cambridge St Ste 102
Las Vegas, NV 89119-7440
Phone
(702) 307-5415
Fax
(702) 307-5416
NPI assigned
Mar 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2495 NV Primary

Addresses

Primary practice location

3900 Cambridge St Ste 102
Las Vegas, NV 89119-7440

Mailing address

3325 Research Way
Carson City, NV 89706-7913
Phone (775) 888-6610

Other identifiers 1

IdentifierTypeStateIssuer
PA2495OtherNVNV PA LICENSE

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
I20210928003812 NV Practitioner - Physician Assistant 1850546987 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Nevada Health Centers Inc Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jsturgill695178@direct.ochin.org
  • Direct secure messaging: jeremey.sturgill.p1@direct.nevadahealthcenters.nextgenshare.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1053686311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 RESEARCH WAY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897067913",
            "telephone_number": "775-888-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CAMBRIDGE ST STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197440",
            "telephone_number": "702-307-5415",
            "fax_number": "702-307-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURGILL",
        "first_name": "JEREMEY",
        "middle_name": "DWAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-19",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV PA LICENSE",
            "identifier": "PA2495",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.