Individual provider Active NPI

Shenakwa Hawkins, APRN, RN

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1306384086
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN002399 Issued in NV
Practice address
2580 N Rancho Dr Ste 103
Las Vegas, NV 89130-3361
Phone
(725) 780-7880
Fax
(725) 780-7890
NPI assigned
Feb 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN002399 NV Primary

Addresses

Primary practice location

2580 N Rancho Dr Ste 103
Las Vegas, NV 89130-3361

Mailing address

2580 N Rancho Dr Ste 103
Las Vegas, NV 89130-3361
Phone (725) 780-7880

Other identifiers 1

IdentifierTypeStateIssuer
100551032MedicaidNV

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
I20170424001684 NV Practitioner - Nurse Practitioner 7719263953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2580 N Rancho Dr
Suite 103
Las Vegas, NV 89130-3361
Phone (702) 265-9298

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN002399NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Care With Purpose Medical Center, LLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

2580 N Rancho Dr
Ste 103
Las Vegas, NV 89130
Phone (702) 265-9298

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": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1306384086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 N RANCHO DR STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303361",
            "telephone_number": "725-780-7880",
            "fax_number": "725-780-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 N RANCHO DR STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303361",
            "telephone_number": "725-780-7880",
            "fax_number": "725-780-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "SHENAKWA",
        "name_prefix": "Mrs.",
        "credential": "APRN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN002399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100551032",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.