Henderson Psychiatry Corporation

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

HENDERSON PSYCHIATRY CORPORATION

Practice address

1070 Wigwam Pkwy Ste 100
Henderson, NV 89074-8178

Phone

(702) 454-0201

NPI assigned

Dec 8, 2023

Organization subpart

No

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

Authorized official

Name

Ansy John, NPNPI 1265660047

Title

Ceo

Phone

(702) 454-0201

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ansy Paul John, APN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1265660047

  Adult Health

  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Russo, RN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1407200413
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1235906330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9490 STONE CASTLE WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891235904",
            "telephone_number": "702-883-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 WIGWAM PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748178",
            "telephone_number": "702-454-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON PSYCHIATRY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "ANSY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-454-0201",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henderson Pediatric Dentistry PC
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• Henderson Primary, Professional LLC
• Henderson Radiology, Inc.
• Henderson Senior Living
• Henderson Senior Living
• Henderson Specialty RX LLC
• Henderson Specialty RX LLC

• Psychiatric/Mental Health Nurse Practitioner in Henderson, NV
• Providers in Henderson, NV by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.