Individual provider Active NPI

Deborah Daugherty, NP

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1083784755
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
873502 Issued in NV
Practice address
3550 W Sahara Ave
Las Vegas, NV 89102-5867
Phone
(866) 389-2727
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71000364A IN
Family Nurse Practitioner 363LF0000X 873502 NV Primary

Addresses

Primary practice location

3550 W Sahara Ave
Las Vegas, NV 89102-5867

Mailing address

3550 W Sahara Ave
Las Vegas, NV 89102-5867
Phone (866) 389-2727

Other practice location 1

3280 E State Road 32
Westfield, IN 46074-8731
Phone (612) 225-1512

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
I20240909000189 NV Practitioner - Nurse Practitioner 0345346888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MC Medical Group of Nevada, P.CGroup PAC ID 1557454410, 30 clinicians

Practice addresses (Care Compare)

3550 W Sahara Ave
Las Vegas, NV 89102-5867
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000364AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MC Medical Group of Nevada, P.C Family CurrentSince Aug 8, 2024 Accepting new patients

Locations

3550 W Sahara Ave
Las Vegas, NV 89102
Phone (702) 566-6061

4755 W Ann Rd
North Las Vegas, NV 89031
Phone (702) 396-2857

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1083784755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891025867",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891025867",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3280 E State Road 32",
            "address_purpose": "LOCATION",
            "city": "Westfield",
            "state": "IN",
            "postal_code": "460748731",
            "country_code": "US",
            "telephone_number": "612-225-1512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "DEBORAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000364A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "873502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.