John Phoenix Aprn PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN001359 Issued in NV

Legal business name

JOHN PHOENIX APRN PLLC

Practice address

2000 S Eastern Ave Ste R
Las Vegas, NV 89104-4100

Phone

(702) 523-9025

Fax

(775) 310-9190

NPI assigned

Aug 28, 2013

Organization subpart

No

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

Authorized official

Name

John R Phoenix, APRNNPI 1013289024

Title

Owner

Phone

(702) 523-9025

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Huntridge Family Clinic Other name

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12653/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John R Phoenix, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1013289024
  Medicare reassignment NPD Authorized official
• Romulus Darden, NP

  • Nurse Practitioner
  • Las Vegas, NV
  • NPI 1962033530
  Medicare reassignment NPD

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722643200000",
    "number": "1134553068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 COCHRAN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043538",
            "telephone_number": "702-523-9025",
            "fax_number": "775-310-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S EASTERN AVE STE R",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891044100",
            "telephone_number": "702-523-9025",
            "fax_number": "775-310-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN PHOENIX APRN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-28",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A",
        "authorized_official_last_name": "PHOENIX",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-523-9025",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100534176",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntridge Family Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Huntridge Family Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.