Individual provider Active NPI

Jessica Rose Brave Heart, MS, LAT, ATC

  • Athletic Trainer
  • North Las Vegas, NV
National Provider Identifier
1275010399
Registry record updated Aug 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT0506788 Issued in NV
Practice address
150 W Deer Springs Way
North Las Vegas, NV 89084-1340
Phone
(605) 899-2863
NPI assigned
Jul 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT0506788 NV Primary

Addresses

Primary practice location

150 W Deer Springs Way
North Las Vegas, NV 89084-1340

Mailing address

5005 Losee Rd
North Las Vegas, NV 89081-2479
Phone (605) 899-2863

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

NPI Registry JSON

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

{
    "created_epoch": "1532131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1275010399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 LOSEE RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890812479",
            "telephone_number": "605-899-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W DEER SPRINGS WAY",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890841340",
            "telephone_number": "605-899-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVE HEART",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-21",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NV",
            "license": "AT0506788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; 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.