Individual provider Active NPI

Jessika Q. F. Mayes, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1326597386
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
815429 Issued in NV
Practice address
1510 W Sunset Rd Ste 110
Henderson, NV 89014-2695
Phone
(702) 861-1875
Fax
(949) 404-6850
NPI assigned
Sep 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 815429 NV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 815429 NV Primary

Addresses

Primary practice location

1510 W Sunset Rd Ste 110
Henderson, NV 89014-2695

Mailing address

2700 Las Vegas Blvd S Unit 2004
Las Vegas, NV 89109-1162
Phone (702) 861-1875

Other practice location 1

2920 N Green Valley Pkwy Ste 812
Henderson, NV 89014-0409
Phone (702) 861-1875

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
I20191022000708 NV Practitioner - Nurse Practitioner 0840579801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fibonacci Services LLCGroup PAC ID 2567794720, 2 clinicians

Practice addresses (Care Compare)

2920 N Green Valley Pkwy
Suite 812
Henderson, NV 89014-0409
Phone (702) 861-1875

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
815429NVMDPsychiatric/Mental Health Nurse Practitioner

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": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1326597386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 LAS VEGAS BLVD S UNIT 2004",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891091162",
            "telephone_number": "702-861-1875",
            "fax_number": "210-892-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 W SUNSET RD STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142695",
            "telephone_number": "702-861-1875",
            "fax_number": "949-404-6850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2920 N Green Valley Pkwy Ste 812",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890140409",
            "country_code": "US",
            "telephone_number": "702-861-1875",
            "fax_number": "210-892-3616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYES",
        "first_name": "JESSIKA",
        "middle_name": "Q. F.",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "815429",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "815429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.