Organization Active NPI

Rose Wellness LV LLC

  • Primary Care Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1194441857
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
ROSE WELLNESS LV LLC
Practice address
8550 W Charleston Blvd Ste 108
Las Vegas, NV 89117-9080
Phone
(725) 210-4900
NPI assigned
Oct 14, 2022
Last updated
Nov 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Authorized official

Name
Rose Jusayan, APRN
Title
Owner
Phone
(702) 355-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NU Primary

Addresses

Primary practice location

8550 W Charleston Blvd Ste 108
Las Vegas, NV 89117-9080

Mailing address

8550 W Charleston Blvd Ste 108
Las Vegas, NV 89117-9080
Phone (725) 210-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221118000624 NV Part B Supplier - Clinic/Group Practice 1658749817 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

8550 W Charleston Blvd
Ste 102
Las Vegas, NV 89117
Phone (702) 435-4090

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1194441857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 W CHARLESTON BLVD STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891179080",
            "telephone_number": "725-210-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 W CHARLESTON BLVD STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891179080",
            "telephone_number": "725-210-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE WELLNESS LV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "JUSAYAN",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-355-3900",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.