Organization Active NPI

JCN Medical LLC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1104771476
Registry record updated Aug 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
JCN MEDICAL LLC
Practice address
9205 W Russell Rd Ste 240
Las Vegas, NV 89148-1425
Phone
(702) 901-2936
NPI assigned
Mar 3, 2026
Reactivated
Aug 27, 2026
Last updated
Aug 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2026

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

Authorized official

Name
J Nunag
Title
Nurse Practitioner
Phone
(702) 901-2935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

9205 W Russell Rd Ste 240
Las Vegas, NV 89148-1425

Mailing address

9205 W Russell Rd Ste 240
Las Vegas, NV 89148-1425

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1772496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787961600000",
    "number": "1104771476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9205 W RUSSELL RD STE 240",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 W RUSSELL RD STE 240",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481425",
            "telephone_number": "702-901-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCN MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "deactivation_date": "2026-04-06",
        "reactivation_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "NUNAG",
        "authorized_official_first_name": "J",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "702-901-2935"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2026; 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.