Individual provider Active NPI

Warren Guinn, PA

  • Medical Physician Assistant
  • Henderson, NV
National Provider Identifier
1104896281
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
589 Issued in NV
Practice address
270 W Lake Mead Pkwy
Henderson, NV 89015-7093
Phone
(702) 877-5199
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X 589 NV Primary

Addresses

Primary practice location

270 W Lake Mead Pkwy
Henderson, NV 89015-7093

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

Other practice location 1

4750 W Oakey Blvd
Las Vegas, NV 89102
Phone (702) 854-2934

Other practice location 2

4750 W Oakey Blvd
Las Vegas, NV 89102
Phone (702) 854-2934

Other practice location 3

101 E Lake Mead Pkwy Ste 110
Henderson, NV 89015-5532
Phone (702) 877-5199

Other identifiers 1

IdentifierTypeStateIssuer
2402112MedicaidNV

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
I20120105000394 NV Practitioner - Physician Assistant 3971778507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Group II Rhodes P C 296 clinicians

Practice addresses (Care Compare)

270 W Lake Mead Pkwy
Henderson, NV 89015-7093
Phone (702) 579-3253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: wguinn121037@westdirect.optum.com

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1104896281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 W LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157093",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4750 W Oakey Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89102",
            "country_code": "US",
            "telephone_number": "702-854-2934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4750 W Oakey Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89102",
            "country_code": "US",
            "telephone_number": "702-854-2934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E Lake Mead Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890155532",
            "country_code": "US",
            "telephone_number": "702-877-5199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUINN",
        "first_name": "WARREN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2402112",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.