Active NPI
Craig Duerson
- Community Health Worker
- Las Vegas, NV
National Provider Identifier
1295218519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 235 N Eastern Ave Ste 102
Las Vegas, NV 89101-4544 - Phone
- (702) 333-1054
- Fax
- (702) 608-7752
- NPI assigned
- Sep 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | NV | Primary |
Addresses
Primary practice location
235 N Eastern Ave Ste 102
Las Vegas, NV 89101-4544
Mailing address
3624 Elegant Saint CT
Las Vegas, NV 89115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053804161 | Medicaid | NV |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trydent Services LLC | Current | Accepting new patients | |
| Trydent Services LLC | Current | Accepting new patients |
Locations
235 N Eastern Ave
Ste 102
Las Vegas, NV 89101
Phone (702) 333-1054
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.
-
- Addiction (Substance Use Disorder) Counselor
- Las Vegas, NV
- NPI 1215607601
-
- Adult Mental Health Clinic/Center
- Las Vegas, NV
- NPI 1619865201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1295218519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3624 ELEGANT SAINT CT",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 N EASTERN AVE STE 102",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891014544",
"telephone_number": "702-333-1054",
"fax_number": "702-608-7752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUERSON",
"first_name": "CRAIG",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-12",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NV",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1053804161",
"state": "NV"
}
],
"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 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.