Jennifer Jane Blevins, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2489 Issued in NV

Practice address

1302 W Craig Rd Ste a
N Las Vegas, NV 89032-0247

Phone

(702) 473-8380

Fax

(702) 473-8383

NPI assigned

Dec 23, 2009

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

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 2

Specialty

Physician Assistant

Education

University of California, Davis School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Holdings Nevada IncGroup PAC ID 7416054622, 311 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jblevins80123@scrippshlth.medalliesdirect.net
• Direct secure messaging: jenniferblevins@hcpnv.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Intermountain Medical Holdings Nevada Inc

  dba Intermountain Health

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279
  Medicare reassignment Care Compare group
• A Nicknam PC

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1659501302
  Medicare reassignment
• La Jolla Spine Institute Medical Group, Inc.

  dba Spine Institute of San Diego

  • Orthopaedic Surgery of the Spine Physician
  • San Diego, CA
  • NPI 1073677811
  Medicare reassignment
• Intermountain Medical Holdings Nevada Inc

  dba Intermountain Health Home Care

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1689882557
  NPD
• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• American River Internal Medicine Associates Inc

  • Internal Medicine Physician
  • Sacramento, CA
  • NPI 1649344342
  NPD (past)
• Monice Kwok, M.D., Inc.

  dba american river internal medicine associates

  • Internal Medicine Physician
  • Sacramento, CA
  • NPI 1386985448
  NPD (past)
• Talbert Medical Group

  • Health Maintenance Organization
  • Costa Mesa, CA
  • NPI 1497759005
  NPD (past)

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1124357066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 W CRAIG RD STE A",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890320247",
            "telephone_number": "702-473-8380",
            "fax_number": "702-473-8383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6040 N. Martin Luther King Blvd",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "89032",
            "country_code": "US",
            "telephone_number": "702-380-1712",
            "fax_number": "877-361-1165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "JENNIFER",
        "middle_name": "JANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20701",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124357066",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA2489",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in N Las Vegas, NV
• Providers in N Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.