NPIMap

Organization Active NPI

Stark Medicine Khurana Jeider PLLC

Doing business as Nevada Mental Health

  • Child & Adolescent Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1053880856
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
STARK MEDICINE KHURANA JEIDER PLLC
Practice address
6600 W Charleston Blvd Ste 140
Las Vegas, NV 89146-1067
Phone
(725) 246-1483
Fax
(866) 518-0781
NPI assigned
Nov 21, 2018
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

Name
Timothy Benjamin James Jeider
Title
Owner
Phone
(702) 350-2906

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Addiction Medicine (Internal Medicine) Physician 207RA0401X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Nurse Practitioner 363L00000X NU
Primary Care Nurse Practitioner 363LP2300X NU

Addresses

Primary practice location

6600 W Charleston Blvd Ste 140
Las Vegas, NV 89146-1067

Mailing address

840 S Rancho Dr Ste 4-903
Las Vegas, NV 89106-3837
Phone (702) 440-8840

Other practice location 1

526 S Tonopah Dr Ste 200
Las Vegas, NV 89106-4013
Phone (725) 246-1483

Other identifiers 1

IdentifierTypeStateIssuer
1053880856MedicaidNV

Other names 1

  • Nevada Mental Health Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190321002980 NV Part B Supplier - Clinic/Group Practice 1557601978 Receives reassigned benefits from 36 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

6600 W Charleston Blvd
Las Vegas, NV 89146
Phone (702) 527-7510

6600 W Charleston Blvd
Ste 102
Las Vegas, NV 89146
Phone (702) 440-8430

840 S Rancho Dr
#4903
Las Vegas, NV 89106
Phone (702) 440-8430

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1053880856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S RANCHO DR STE 4-903",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063837",
            "telephone_number": "702-440-8840",
            "fax_number": "866-518-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 W CHARLESTON BLVD STE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461067",
            "telephone_number": "725-246-1483",
            "fax_number": "866-518-0781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "526 S Tonopah Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064013",
            "country_code": "US",
            "telephone_number": "725-246-1483",
            "fax_number": "866-518-0781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STARK MEDICINE KHURANA JEIDER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "JEIDER",
        "authorized_official_first_name": "TIMOTHY BENJAMIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-350-2906"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053880856",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nevada Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nevada Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nevada Mental Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.