Individual provider Active NPI

Joanne L Wennstrom, APRN-CPNP-PC

  • Pediatric Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1235645003
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN-CNP882242 Issued in NV
Practice address
3201 S Maryland Pkwy Ste 608
Las Vegas, NV 89109-2428
Phone
(702) 457-5437
Fax
(702) 464-5801
NPI assigned
Dec 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN-CNP882242 NV Primary
Pediatrics Physician 208000000X F382758-1 NY

Addresses

Primary practice location

3201 S Maryland Pkwy Ste 608
Las Vegas, NV 89109-2428

Mailing address

PO Box 845498
Los Angeles, CA 90084-2611
Phone (702) 457-5437

Other practice location 1

880 Seven Hills Dr Ste 100
Henderson, NV 89052-4372
Phone (702) 457-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180206000395 NY Practitioner - Nurse Practitioner 0547520827 Reassigns benefits to 1 organization
I20260113002604 NV Practitioner - Nurse Practitioner 0547520827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

101 W County Line Rd
Suite 230
Highlands Ranch, CO 80129-1903

PO Box
Los Angeles, CA 90084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F382758-1NYMDPediatrics Physician
APRN-CNP882242NVMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harold Zilberman M D CHTD Pediatrics CurrentSince Nov 1, 2025 Accepting new patients
Albany Medical College CurrentSince Dec 30, 2017 Accepting new patients
Albany Medical College CurrentSince Dec 30, 2017 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Pediatrics CurrentSince Jun 1, 2019 Accepting new patients
Albany Medical College Pediatrics Current Accepting new patients

Locations

880 Seven Hills Dr
Ste 100
Henderson, NV 89052
Phone (702) 457-5437

3201 S Maryland Pkwy
Ste 608
Las Vegas, NV 89109
Phone (702) 457-5437

50 New Scotland Ave
Albany, NY 12208
Phone (518) 262-0940

47 New Scotland Ave
#61
Albany, NY 12208
Phone (518) 262-5791

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
Menands, NY 12204
Phone (518) 262-9705

Organizations & group practices 7

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": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1235645003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845498",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900842611",
            "telephone_number": "702-457-5437",
            "fax_number": "702-464-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S MARYLAND PKWY STE 608",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092428",
            "telephone_number": "702-457-5437",
            "fax_number": "702-464-5801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 Seven Hills Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890524372",
            "country_code": "US",
            "telephone_number": "702-457-5437",
            "fax_number": "702-464-5801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENNSTROM",
        "first_name": "JOANNE",
        "middle_name": "L",
        "credential": "APRN-CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-15",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NV",
            "license": "APRN-CNP882242",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "F382758-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.