Individual provider Active NPI

Cheryl Lynn Roberts, RN

  • Case Management Registered Nurse
  • Las Vegas, NV
National Provider Identifier
1265201339
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
RN36769 Issued in NV
Practice address
4040 S Eastern Ave Ste 300
Las Vegas, NV 89119-0854
Phone
(702) 463-0300
Fax
(702) 463-0301
NPI assigned
Dec 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X RN36769 NV Primary

Addresses

Primary practice location

4040 S Eastern Ave Ste 300
Las Vegas, NV 89119-0854

Mailing address

9165 Promising CT
Las Vegas, NV 89149-0479
Phone (702) 506-7211

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN36769NVMDCase Management Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jed Adam Enterprises, LLC CurrentSince Dec 31, 2023 Accepting new patients

Locations

4040 S Eastern Ave
Ste 300
Las Vegas, NV 89119
Phone (702) 463-0300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1265201339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9165 PROMISING CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490479",
            "telephone_number": "702-506-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 S EASTERN AVE STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891190854",
            "telephone_number": "702-463-0300",
            "fax_number": "702-463-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NV",
            "license": "RN36769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.