Individual provider Active NPI

Jon Failla, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1326474685
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002252 Issued in NV
Practice address
4270 S Decatur Blvd Ste B6
Las Vegas, NV 89103-6802
Phone
(702) 485-2100
Fax
(702) 825-0091
NPI assigned
Sep 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN61345 NV
Psychiatric/Mental Health Registered Nurse 163WP0808X APRN002252 NV
Family Nurse Practitioner 363LF0000X APRN002252 NV Primary

Addresses

Primary practice location

4270 S Decatur Blvd Ste B6
Las Vegas, NV 89103-6802

Mailing address

182 Apache Tear CT
Las Vegas, NV 89123-2996
Phone (702) 546-6864

Other identifiers 2

IdentifierTypeStateIssuer
APRN002252OtherNVNEVADA STATE BOARD OF NURSING
RN61345OtherNVNEVADA STATE BOARD OF NURSING

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
I20170313001471 NV Practitioner - Nurse Practitioner 1557645546 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN61345NVMDPsychiatric/Mental Health Registered Nurse
APRN002252NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Homebase Care Casal PLLC CurrentSince Jun 1, 2021 Accepting new patients
State of Nevada Current Accepting new patients
Medtrans Medical Nevada Casal PLLC Current Accepting new patients
Homebase Care Casal PLLC CurrentSince Jun 1, 2021 Accepting new patients
Southern Nevada Adult Mental Health CurrentSince Mar 1, 2022 Accepting new patients
State of Nevada CurrentSince Mar 1, 2022 Accepting new patients
Bhushan Manjooran Wirjo & Associates PLLC Past Accepting new patients

Locations

4150 Technology Way
Ste 100
Carson City, NV 89706

3312 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 410-7825

1909 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 471-0420

5412 Boulder Hwy
Las Vegas, NV 89122

850 Mill St
Ste 100
Reno, NV 89502
Phone (775) 982-3950

Organizations & group practices 7

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": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1326474685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 APACHE TEAR CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891232996",
            "telephone_number": "702-546-6864",
            "fax_number": "775-251-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 S DECATUR BLVD STE B6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891036802",
            "telephone_number": "702-485-2100",
            "fax_number": "702-825-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAILLA",
        "first_name": "JON",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-18",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NV",
            "license": "RN61345",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NV",
            "license": "APRN002252",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE BOARD OF NURSING",
            "identifier": "APRN002252",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE BOARD OF NURSING",
            "identifier": "RN61345",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.