Individual provider Active NPI

Adrienne Kemp, APRN FNP-C

  • Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1184092272
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
825719 Issued in NV
Practice address
270 W Lake Mead Pkwy
Henderson, NV 89015-7093
Phone
(702) 877-5199
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 168226 GA
Nurse Practitioner 363L00000X 825719 NV Primary

Addresses

Primary practice location

270 W Lake Mead Pkwy
Henderson, NV 89015-7093

Mailing address

300 Dandelion Cir
McDonough, GA 30252-3717
Phone (404) 477-7390

Other practice location 1

2 North Zack Hinton Parkway,
Minute Clinic
McDonough, GA 30252-3717
Phone (999) 999-9999

Other names 1

  • Adrienne Diane Simpson Former name

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
I20200217004254 NV Practitioner - Nurse Practitioner 9739498262 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
168226GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc CurrentSince Jan 2, 2020 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Jan 2, 2020 Accepting new patients

Locations

270 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 677-3720

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1184092272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 DANDELION CIR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302523717",
            "telephone_number": "404-477-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 W LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157093",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 North Zack Hinton Parkway,",
            "address_2": "Minute Clinic",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302523717",
            "country_code": "US",
            "telephone_number": "999-999-9999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEMP",
        "first_name": "ADRIENNE",
        "credential": "APRN FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "168226",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "825719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "SIMPSON",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.