Individual provider Active NPI

Erin E Reddis, D.O.

  • Adult Medicine Physician
  • Nellis Afb, NV
National Provider Identifier
1114368024
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
1254 Issued in NE
Practice address
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone
(702) 653-2764
NPI assigned
Jul 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1254 NE
Adult Medicine Physician 207QA0505X 1254 NE Primary

Addresses

Primary practice location

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600

Mailing address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone (702) 653-2273

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251015000011 NV Practitioner - Family Practice 2961729157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

2724 N Tenaya Way
FL 2
Las Vegas, NV 89128-0424
Phone (702) 939-8557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1254NEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Aug 12, 2025 Accepting new patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Aug 12, 2025 Accepting new patients

Locations

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

2724 N Tenaya Way
Fl 2
Las Vegas, NV 89128
Phone (702) 939-8557

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

Organizations & group practices 3

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": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1114368024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDIS",
        "first_name": "ERIN",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1254",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NE",
            "license": "1254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nellis Afb, NV

Sources for this page

Verify at the official NPI Registry.