Active NPI
Meilan L Daguman, AGPCNP
- Nurse Practitioner
- Las Vegas, NV
National Provider Identifier
1083089874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN002088
- Practice address
- 4560 S Eastern Ave Ste 15
Las Vegas, NV 89119-6182 - Phone
- (702) 994-7267
- Fax
- (702) 623-5995
- NPI assigned
- Dec 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 002088 | NV | |
| Nurse Practitioner | 363L00000X | APRN002088 | NV | Primary |
Addresses
Primary practice location
4560 S Eastern Ave Ste 15
Las Vegas, NV 89119-6182
Mailing address
7104 Carmen Blvd
Las Vegas, NV 89128-3430
Phone (702) 815-6350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4560 S Eastern Ave
Suite 15
Las Vegas, NV 89119-6182
Phone (702) 994-7267
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002088 | NV | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meilan L Daguman Aprn PLLC | Multi-Specialty | Current | Accepting new patients |
| Guanaroca Medical Center Inc | Multi-Specialty | Past | Accepting new patients |
Locations
4560 S Eastern Ave
Ste 15
Las Vegas, NV 89119
Phone (702) 401-0811
2842 E Lake Mead Blvd
North Las Vegas, NV 89030
Phone (702) 314-2400
Interoperability endpoints
- meilan.daguman.1@28155.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Primary Care Nurse Practitioner
- Las Vegas, NV
- NPI 1023568037
Multi-Specialty
-
- Primary Care Clinic/Center
- Las Vegas, NV
- NPI 1568032548
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1083089874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7104 CARMEN BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891283430",
"telephone_number": "702-815-6350",
"fax_number": "702-623-5995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 S EASTERN AVE STE 15",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891196182",
"telephone_number": "702-994-7267",
"fax_number": "702-623-5995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAGUMAN",
"first_name": "MEILAN",
"middle_name": "L",
"credential": "AGPCNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-06",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NV",
"license": "002088",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NV",
"license": "APRN002088",
"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 Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.