Individual provider Active NPI

Jonas Basilio Vargas

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Henderson, NV
National Provider Identifier
1083458228
Registry record updated Jun 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
878964 Issued in NV
Practice address
57 Evvie CT
Henderson, NV 89012-5980
Phone
(702) 481-5955
NPI assigned
Jun 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 878964 NV Primary

Addresses

Primary practice location

57 Evvie CT
Henderson, NV 89012-5980

Mailing address

57 Evvie CT
Henderson, NV 89012-5980
Phone (702) 481-5955

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

State licenses

LicenseStateTypeSpecialty
878964NVMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1083458228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 EVVIE CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890125980",
            "telephone_number": "702-481-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 EVVIE CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890125980",
            "telephone_number": "702-481-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "JONAS",
        "middle_name": "BASILIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NV",
            "license": "878964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; 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.