Active NPI
Michael Taylor McClellan, PA
- Physician Assistant
- North Las Vegas, NV
National Provider Identifier
1063906972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12164406-1206
- Practice address
- 6900 N Pecos Rd
North Las Vegas, NV 89086-4400 - Phone
- (702) 791-9000
- NPI assigned
- Jun 15, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12164406-1206 | UT | Primary |
Addresses
Primary practice location
6900 N Pecos Rd
North Las Vegas, NV 89086-4400
Mailing address
6900 N Pecos Rd
North Las Vegas, NV 89086-4400
Phone (702) 791-9000
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12164406-1206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746489600000",
"number": "1063906972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6900 N PECOS RD",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890864400",
"telephone_number": "702-791-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6900 N PECOS RD",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890864400",
"telephone_number": "702-791-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLELLAN",
"first_name": "MICHAEL",
"middle_name": "TAYLOR",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-15",
"last_updated": "2025-05-06",
"certification_date": "2025-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "12164406-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.