Individual provider Active NPI

Clarence Quentin Thomas Collins, EMT-P, PA

  • Basic Emergency Medical Technician
  • Las Vegas, NV
National Provider Identifier
1063129880
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
0652-4023-4638 Issued in NV
Practice address
3811 W Charleston Blvd
Las Vegas, NV 89102-1836
Phone
(702) 468-5516
NPI assigned
Nov 1, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 0652-4023-4638 NV Primary

Addresses

Primary practice location

3811 W Charleston Blvd
Las Vegas, NV 89102-1836

Mailing address

3811 W Charleston Blvd Ste 205
Las Vegas, NV 89102-1846
Phone (702) 468-5516

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)
Not enrolled
Credentials
Emergency Medical Technician - Paramedic, Physician Assistant

State licenses

LicenseStateTypeSpecialty
0652-4023-4638NVMDBasic Emergency Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1063129880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 W CHARLESTON BLVD STE 205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021846",
            "telephone_number": "702-468-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021836",
            "telephone_number": "702-468-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CLARENCE",
        "middle_name": "QUENTIN THOMAS",
        "name_prefix": "Mr.",
        "credential": "EMT-P, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-01",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NV",
            "license": "0652-4023-4638",
            "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 Mar 3, 2026; 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.