Individual provider Active NPI

Rocio Kaelin

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1265291009
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
828292 Issued in NV
Practice address
6301 Mountain Vista St Ste 209
Henderson, NV 89014-2366
Phone
(702) 703-1202
NPI assigned
Mar 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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 828292 NV Primary

Addresses

Primary practice location

6301 Mountain Vista St Ste 209
Henderson, NV 89014-2366

Mailing address

10500 Clark Petersen Blvd
Las Vegas, NV 89165-1802
Phone (702) 644-2468

Other practice location 1

10500 Clark Petersen Blvd
Las Vegas, NV 89165-1802
Phone (702) 644-2468

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
I20240426003515 NV Practitioner - Nurse Practitioner 5395185144 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
828292NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Care Connections, LLC. CurrentSince May 6, 2024 Accepting new patients
Revolution Health LLC Family CurrentSince Mar 31, 2024 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

6301 Mountain Vista St
Ste 209
Henderson, NV 89014
Phone (702) 703-1202

8329 W Sunset Rd
Ste 100
Las Vegas, NV 89113

Interoperability endpoints

  • Direct secure messaging: rkaelin16489@direct-prd.molinahealthcare.com

Organizations & group practices 2

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": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1265291009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 CLARK PETERSEN BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891651802",
            "telephone_number": "702-644-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 MOUNTAIN VISTA ST STE 209",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142366",
            "telephone_number": "702-703-1202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10500 Clark Petersen Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891651802",
            "country_code": "US",
            "telephone_number": "702-644-2468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAELIN",
        "first_name": "ROCIO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "828292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.