Jaclyn De Groot, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN001611 Issued in NV

Practice address

4505 S Maryland Pkwy
Las Vegas, NV 89154-9900

Phone

(702) 895-3370

NPI assigned

Feb 28, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• University of Nevada Las Vegas

  • Student Health Clinic/Center
  • Las Vegas, NV
  • NPI 1326474818
  NPD (past)

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1306186259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 S MARYLAND PKWY # 453020",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891549900",
            "telephone_number": "702-895-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891549900",
            "telephone_number": "702-895-3370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 Lakewood Blvd",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "902404020",
            "country_code": "US",
            "telephone_number": "562-862-3684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE GROOT",
        "first_name": "JACLYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-28",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22234",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Julia De Dmon, DPT
• Angela De Froda
• Alea De Garcia
• Antoineta De Gracia
• Jonathan D De Graff, CADC
• Lauren Rivera De Guia-Lapuz, PT
• Evangeline Auyong De Guzman-Delaluz, NP
• Mary Joy Inoceda De Guzman-Walters, RD
• Amirose De Guzman
• Anthony Cruz De Guzman

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.