Individual provider Active NPI

Mary Elizabeth Wardle, MSN, APRN,FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1235624388
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002872 Issued in NV
Practice address
2650 N Tenaya Way Ste 302
Las Vegas, NV 89128-1112
Phone
(702) 240-0088
Fax
(702) 240-3049
NPI assigned
Jun 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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 APRN002872 NV
Family Nurse Practitioner 363LF0000X APRN002872 NV Primary

Addresses

Primary practice location

2650 N Tenaya Way Ste 302
Las Vegas, NV 89128-1112

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other practice location 1

3841 W Charleston Blvd Ste 201
Las Vegas, NV 89102-1858
Phone (702) 848-4443

Other identifiers 2

IdentifierTypeStateIssuer
1235624388MedicaidNV
APRN002872OtherNVSTATE LICENSE

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
I20190226001994 NV Practitioner - Nurse Practitioner 5193064707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Medical Holdings Nevada IncGroup PAC ID 7416054622, 311 clinicians

Practice addresses (Care Compare)

2650 N Tenaya Way
Suite 360
Las Vegas, NV 89128-1102
Phone (702) 240-0088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN002872NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Medical Group Coats LTD Family Medicine Current Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Intermountain Medical Holdings Nevada Inc Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
True North Health Navigation LLC Past Accepting new patients
Talbert Medical Group PastSince Nov 12, 2018 Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Dignity Health Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

2650 N Tenaya Way
Ste 360
Las Vegas, NV 89128
Phone (702) 240-0088

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Interoperability endpoints

  • Direct secure messaging: marywardle@hcpnv.allscriptsdirect.net

Organizations & group practices 11

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": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1235624388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 N TENAYA WAY STE 302",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281112",
            "telephone_number": "702-240-0088",
            "fax_number": "702-240-3049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3841 W Charleston Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021858",
            "country_code": "US",
            "telephone_number": "702-848-4443",
            "fax_number": "702-805-0299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARDLE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "MSN, APRN,FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN002872",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235624388",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN002872",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.