Active NPI
Mika Martin
- Psychiatric/Mental Health Nurse Practitioner
- Las Vegas, NV
National Provider Identifier
1306653043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 88704
- Practice address
- 6955 N Durango Dr
Las Vegas, NV 89149-4411 - Phone
- (702) 250-0063
- NPI assigned
- Dec 16, 2024
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 88704 | NV | Primary |
Addresses
Primary practice location
6955 N Durango Dr
Las Vegas, NV 89149-4411
Mailing address
6955 N Durango Dr
Las Vegas, NV 89149-4411
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88704 | NV | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734307200000",
"number": "1306653043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6955 N DURANGO DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891494411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6955 N DURANGO DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891494411",
"telephone_number": "702-250-0063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MIKA",
"sole_proprietor": "YES",
"sex": "U",
"enumeration_date": "2024-12-16",
"last_updated": "2024-12-16",
"certification_date": "2024-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NV",
"license": "88704",
"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 Dec 16, 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.