Individual provider Active NPI

Ray Montenegro, FNP

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1275978579
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F1212409 Issued in NV
Practice address
6655 W Sahara Ave
Suite D-110
Las Vegas, NV 89146-0842
Phone
(972) 996-0900
Fax
(972) 996-0905
NPI assigned
May 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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 F1212409 NV Primary

Addresses

Primary practice location

6655 W Sahara Ave
Suite D-110
Las Vegas, NV 89146-0842

Mailing address

6655 W Sahara Ave
Suite D-110
Las Vegas, NV 89146-0842
Phone (972) 996-0900

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

State licenses

LicenseStateTypeSpecialty
F1212409NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DMC Medical Clinic LTD PastSince Mar 11, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1275978579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 W SAHARA AVE",
            "address_2": "SUITE D-110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460842",
            "telephone_number": "972-996-0900",
            "fax_number": "972-996-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 W SAHARA AVE",
            "address_2": "SUITE D-110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460842",
            "telephone_number": "972-996-0900",
            "fax_number": "972-996-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTENEGRO",
        "first_name": "RAY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "F1212409",
            "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 May 1, 2013; 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.