Individual provider Active NPI

Charisse Lachica Kokseng, NP-C, WCS-C, EDS-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1255908695
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
841867 Issued in NV
Practice address
9490 Veterans CT
Las Vegas, NV 89148-4631
Phone
(702) 867-0800
Fax
(866) 384-4453
NPI assigned
Jun 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 841867 NV Primary

Addresses

Primary practice location

9490 Veterans CT
Las Vegas, NV 89148-4631

Mailing address

9490 Veterans CT
Las Vegas, NV 89148-4631
Phone (702) 867-0800

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
I20220104001261 NV Practitioner - Nurse Practitioner 9739570623 Reassigns benefits to 1 organization
Practice locations: Las Vegas, NV

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
841867NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Snow LLC Family CurrentSince Mar 1, 2024 Accepting new patients
Universal Medical Alliance Inc. CurrentSince Aug 18, 2023 Accepting new patients
Warm Springs Road CVS LLC PastSince Oct 1, 2021 Accepting new patients

Locations

6268 Spring Mountain Rd
Ste 115
Las Vegas, NV 89146
Phone (725) 204-1017

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1255908695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9490 VETERANS CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484631",
            "telephone_number": "702-867-0800",
            "fax_number": "866-384-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9490 VETERANS CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484631",
            "telephone_number": "702-867-0800",
            "fax_number": "866-384-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKSENG",
        "first_name": "CHARISSE",
        "middle_name": "LACHICA",
        "name_prefix": "Mrs.",
        "credential": "NP-C, WCS-C, EDS-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "841867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.