Active NPI
Patricia Darlene McClellan, PA-C
- Physician Assistant
- North Las Vegas, NV
National Provider Identifier
1316966617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-C48
- Practice address
- 3960 W Craig Rd
Suite 101
North Las Vegas, NV 89032-2731 - Phone
- (702) 473-8380
- Fax
- (702) 473-8383
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-C48 | NV | Primary |
Addresses
Primary practice location
3960 W Craig Rd
Suite 101
North Las Vegas, NV 89032-2731
Mailing address
PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316966617 | 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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48 | NV | MD | Audiologist-Hearing Aid Fitter |
| PA-C48 | NV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anthony L Pollard DO a Professional Corporation | Past | Accepting new patients | |
| Intermountain Medical Holdings Nevada Inc | Past | Accepting new patients | |
| Canyon Gate Medical Group, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Rainbow Medical Centers
- Family Medicine Physician
- Las Vegas, NV
- NPI 1518189745
-
- Internal Medicine Physician
- Las Vegas, NV
- NPI 1831347731
-
dba Intermountain Health
- Internal Medicine Physician
- Henderson, NV
- NPI 1245997279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1316966617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 98978",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891938978",
"telephone_number": "702-216-3346",
"fax_number": "702-671-6883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3960 W CRAIG RD",
"address_2": "SUITE 101",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890322731",
"telephone_number": "702-473-8380",
"fax_number": "702-473-8383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLELLAN",
"first_name": "PATRICIA",
"middle_name": "DARLENE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA-C48",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1316966617",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.