Individual provider Active NPI

Tina S Shumard, FNP-BC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1124701941
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
865713 Issued in NV
Practice address
1825 E Warm Springs Rd
Las Vegas, NV 89119-4547
Phone
(866) 389-2727
NPI assigned
Aug 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 865713 NV Primary

Addresses

Primary practice location

1825 E Warm Springs Rd
Las Vegas, NV 89119-4547

Mailing address

1825 E Warm Springs Rd
Las Vegas, NV 89119-4547
Phone (866) 389-2727

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
I20231110000950 NV Practitioner - Nurse Practitioner 7911354089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MC Medical Group of Nevada, P.CGroup PAC ID 1557454410, 30 clinicians

Practice addresses (Care Compare)

1825 E Warm Springs Rd
Las Vegas, NV 89119-4547
Phone (866) 388-2727

Merit-based Incentive Payment System (MIPS)

Final score
79.58 of 100Reported as group
Quality
71.81
Improvement activities
40
Cost
83.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
865713NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MC Medical Group of Nevada, P.C Family CurrentSince Oct 16, 2023 Accepting new patients

Locations

1825 E Warm Springs Rd
Las Vegas, NV 89119
Phone (702) 361-4873

4755 W Ann Rd
North Las Vegas, NV 89031
Phone (702) 396-2857

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

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": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1124701941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 E WARM SPRINGS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194547",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 E WARM SPRINGS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194547",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMARD",
        "first_name": "TINA",
        "middle_name": "S",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "865713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.