Individual provider Active NPI

Carey J Roselee, RN, MSN, CPNP-BC

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1093181406
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN002009 Issued in NV
Practice address
657 N Town Center Dr
Las Vegas, NV 89144-6367
Phone
(702) 259-1228
NPI assigned
Aug 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN002009 NV
Critical Care Pediatric Nurse Practitioner 363LP0222X APRN002009 NV
Nurse Practitioner 363L00000X APRN002009 NV Primary

Addresses

Primary practice location

657 N Town Center Dr
Las Vegas, NV 89144-6367

Mailing address

350 S Jones Blvd Ste 203
Las Vegas, NV 89107-2623
Phone (702) 703-4917

Other practice location 1

350 S Jones Blvd Ste 7509
Las Vegas, NV 89107-2623
Phone (702) 703-4917

Other names 1

  • Miss Carey Kolvoord Former name

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
I20151024000060 NV Practitioner - Nurse Practitioner 3072822493 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
APRN002009NVMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC Nurse Practitioner CurrentSince Sep 15, 2015 Accepting new patients
Shadow Emergency Physicians PLLC Nurse Practitioner CurrentSince Sep 15, 2015 Accepting new patients

Locations

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

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": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1093181406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S JONES BLVD STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072623",
            "telephone_number": "702-703-4917",
            "fax_number": "866-460-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 N TOWN CENTER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446367",
            "telephone_number": "702-259-1228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 S Jones Blvd Ste 7509",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891072623",
            "country_code": "US",
            "telephone_number": "702-703-4917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSELEE",
        "first_name": "CAREY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, CPNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NV",
            "license": "APRN002009",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "NV",
            "license": "APRN002009",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN002009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAREY",
            "last_name": "KOLVOORD",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.