Active NPI
Rodrick Keoni Ugale Raquedan
- Family Nurse Practitioner
- Las Vegas, NV
National Provider Identifier
1194638775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 906413
- Practice address
- 8191 Dancing Bull CT
Las Vegas, NV 89139-6901 - Phone
- (808) 741-6372
- NPI assigned
- Sep 24, 2026
- Last updated
- Sep 24, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 906413 | NV | Primary |
Addresses
Primary practice location
8191 Dancing Bull CT
Las Vegas, NV 89139-6901
Mailing address
8191 Dancing Bull CT
Las Vegas, NV 89139-6901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 906413 | NV | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790208000000",
"number": "1194638775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8191 DANCING BULL CT",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891396901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8191 DANCING BULL CT",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891396901",
"telephone_number": "808-741-6372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAQUEDAN",
"first_name": "RODRICK",
"middle_name": "KEONI UGALE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-24",
"last_updated": "2026-09-24",
"certification_date": "2026-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NV",
"license": "906413",
"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 Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.