JCN Medical LLC

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

Organization subpart

No

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

Addresses

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": []
}

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• 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.

Verify at the official NPI Registry.