Individual provider Active NPI

William Wesley Jennings III, M.D.

  • Obstetrics & Gynecology Physician
  • Henderson, NV
National Provider Identifier
1245280908
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
17694 Issued in NV
Practice address
1050 W Galleria Dr
Henderson, NV 89011-4800
Phone
(702) 963-7000
Fax
(702) 333-8466
NPI assigned
May 11, 2006
Last updated
Apr 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 39891 CO
Obstetrics & Gynecology Physician 207V00000X 17694 NV Primary

Addresses

Primary practice location

1050 W Galleria Dr
Henderson, NV 89011-4800

Mailing address

2345 E Prater Way Ste 207
Sparks, NV 89434-9634
Phone (775) 356-4067

Other practice location 1

4010 Jerry Murphy Road
Pueblo, CO 81001-1045
Phone (719) 546-2229

Other identifiers 2

IdentifierTypeStateIssuer
1245280908MedicaidNV
78328829MedicaidCO

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17694NVMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alcott Medical Partners, P.C. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1245280908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 E PRATER WAY STE 207",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349634",
            "telephone_number": "775-356-4067",
            "fax_number": "702-333-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W GALLERIA DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114800",
            "telephone_number": "702-963-7000",
            "fax_number": "702-333-8466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4010 Jerry Murphy Road",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810011045",
            "country_code": "US",
            "telephone_number": "719-546-2229",
            "fax_number": "719-583-9069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "WILLIAM",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "39891",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "17694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245280908",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78328829",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.