Individual provider Active NPI

Katrina Bidwell, APRN, FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1194407452
Registry record updated Nov 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
823161 Issued in NV
Practice address
3909 S Maryland Pkwy Ste 314
Las Vegas, NV 89119-7520
Phone
(702) 714-1848
NPI assigned
Aug 4, 2023
Last updated
Nov 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2024

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 823161 NV Primary

Addresses

Primary practice location

3909 S Maryland Pkwy Ste 314
Las Vegas, NV 89119-7520

Mailing address

3909 S Maryland Pkwy Ste 314
Las Vegas, NV 89119-7520

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
I20241101002253 NV Practitioner - Nurse Practitioner 8325295777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carefirst Urgent Care LLCGroup PAC ID 3779901939, 20 clinicians

Practice addresses (Care Compare)

4360 Blue Diamond Rd
Suite 103
Las Vegas, NV 89139-7785
Phone (513) 847-6778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
823161NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carefirst Urgent Care, LLC CurrentSince Oct 26, 2024 Accepting new patients
St Marys Healthcare Corp. Current Accepting new patients
Elite Care Providers LLC CurrentSince Feb 23, 2025 Accepting new patients
Clinic 21 of Nevada Zyniewicz PLLC PastSince Sep 1, 2015 Accepting new patients
CG Medical Associates Inc Past Accepting new patients

Locations

4360 Blue Diamond Rd
Ste 103
Las Vegas, NV 89139
Phone (702) 407-0524

5216 Boulder Hwy
Ste 105
Las Vegas, NV 89122
Phone (513) 846-6778

7300 Beechmont Ave
Cincinnati, OH 45230
Phone (513) 232-9100

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brilliant Health System IncLas Vegas, NV, CCN 297235 Home health agency W-2 Managing Employee (100%) Jun 16, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1194407452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 S MARYLAND PKWY STE 314",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 S MARYLAND PKWY STE 314",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197520",
            "telephone_number": "702-714-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIDWELL",
        "first_name": "KATRINA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-04",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "823161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.