Individual provider Active NPI

Paola Camille Ponce, FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1083205736
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
836044 Issued in NV
Practice address
6930 S Cimarron Rd Ste 260
Las Vegas, NV 89113-2135
Phone
(702) 476-9700
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 836044 NV Primary

Addresses

Primary practice location

6930 S Cimarron Rd Ste 260
Las Vegas, NV 89113-2135

Mailing address

6930 S Cimarron Rd Ste 260
Las Vegas, NV 89113-2135
Phone (702) 476-9700

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210415001677 NV Practitioner - Nurse Practitioner 2769890557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6930 S Cimarron Rd
Suite 260
Las Vegas, NV 89113-2135
Phone (702) 476-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
836044NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Wellness and Pain Care of Las Vegas, Inc. CurrentSince Mar 1, 2021 Accepting new patients
Center for Wellness and Pain Care of Las Vegas Inc CurrentSince Mar 1, 2021 Accepting new patients

Locations

1701 N Green Valley Pkwy
Ste 7B
Henderson, NV 89074
Phone (702) 476-9700

8915 S Pecos Rd
Ste 19A
Henderson, NV 89074
Phone (702) 341-9000

6930 S Cimarron Rd
Ste 260
Las Vegas, NV 89113
Phone (702) 476-9700

401 N Buffalo Dr
Ste 202
Las Vegas, NV 89145
Phone (702) 476-9700

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.

NPI Registry JSON

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1083205736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6930 S CIMARRON RD STE 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132135",
            "telephone_number": "702-476-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 S CIMARRON RD STE 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132135",
            "telephone_number": "702-476-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE",
        "first_name": "PAOLA",
        "middle_name": "CAMILLE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "836044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.