Individual provider Active NPI

Nicole C Okeke, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1164752879
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN001146 Issued in NV
Practice address
4270 S Decatur Blvd Ste B6
Las Vegas, NV 89103-6802
Phone
(702) 485-2100
Fax
(702) 825-0091
NPI assigned
Dec 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN 001146 NV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN001146 NV Primary

Addresses

Primary practice location

4270 S Decatur Blvd Ste B6
Las Vegas, NV 89103-6802

Mailing address

3085 E Flamingo Rd Ste a
Las Vegas, NV 89121-4385
Phone (702) 436-0835

Other practice location 1

3085 E Flamingo Rd Ste A
Las Vegas, NV 89121-4385
Phone (702) 436-0835

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
I20120410000262 NV Practitioner - Nurse Practitioner 7810158300 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restored Mind Psychiatric ServicesGroup PAC ID 4385040609, 2 clinicians

Practice addresses (Care Compare)

500 N Rainbow Blvd
Suite 300
Las Vegas, NV 89107-1061
Phone (702) 508-6608

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN 001146NVMDNurse Practitioner
APN001146NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Restored Mind Psychiatric Services Psychiatric/Mental Health CurrentSince Jun 1, 2021 Accepting new patients
Medtrans Medical Nevada Casal PLLC CurrentSince Jun 1, 2021 Accepting new patients
Homebase Care Casal PLLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

3312 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 410-7825

5412 Boulder Hwy
Las Vegas, NV 89122

500 N Rainbow Blvd
Ste 300
Las Vegas, NV 89107
Phone (702) 389-1148

850 Mill St
Ste 100
Reno, NV 89502
Phone (775) 982-3950

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1164752879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 E FLAMINGO RD STE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891214385",
            "telephone_number": "702-436-0835",
            "fax_number": "702-435-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 S DECATUR BLVD STE B6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891036802",
            "telephone_number": "702-485-2100",
            "fax_number": "702-825-0091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3085 E Flamingo Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891214385",
            "country_code": "US",
            "telephone_number": "702-436-0835",
            "fax_number": "702-435-6212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKEKE",
        "first_name": "NICOLE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-31",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APN 001146",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "APN001146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.