Individual provider Active NPI

Amy L. J. King, NP

  • Family Nurse Practitioner
  • N Las Vegas, NV
National Provider Identifier
1083322267
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
857158 Issued in NV
Practice address
1302 W Craig Rd Ste a
N Las Vegas, NV 89032-0247
Phone
(702) 473-8380
Fax
(702) 473-8383
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 857158 NV
Family Nurse Practitioner 363LF0000X 857158 NV Primary

Addresses

Primary practice location

1302 W Craig Rd Ste a
N Las Vegas, NV 89032-0247

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other identifiers 2

IdentifierTypeStateIssuer
1083322267MedicaidNV
857158OtherNVSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Amy.King1@imail.org

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
I20230207001908 NV Practitioner - Nurse Practitioner 0749652493 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc Family Medicine CurrentSince Jan 9, 2023 Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 9, 2023 Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients
Dignity Health Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

6170 N Durango Dr
Ste 130
Las Vegas, NV 89149
Phone (702) 940-1550

3131 La Canada St
Ste 200
Las Vegas, NV 89169
Phone (702) 369-5582

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

1302 W Craig Rd
Ste A
North Las Vegas, NV 89032
Phone (702) 473-8380

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Interoperability endpoints

  • Direct secure messaging: amy.king1@imail.org

Organizations & group practices 8

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": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1083322267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 W CRAIG RD STE A",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890320247",
            "telephone_number": "702-473-8380",
            "fax_number": "702-473-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "AMY",
        "middle_name": "L. J.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NV",
            "license": "857158",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "857158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083322267",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "857158",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Amy.King1@imail.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "1302 W Craig Rd Ste A",
            "city": "N Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890320247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in N Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.