Individual provider Active NPI

Mary Denisse Toribio, NP- NEVADA -835711

  • Adult Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1326649468
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
835711 Issued in NV
Practice address
6240 N Durango Dr Ste 120
Las Vegas, NV 89149-3941
Phone
(954) 923-7440
Fax
(954) 923-1299
NPI assigned
Nov 5, 2020
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 835711 NV Primary
Gerontology Nurse Practitioner 363LG0600X 835711 NV
Primary Care Nurse Practitioner 363LP2300X 835711 NV

Addresses

Primary practice location

6240 N Durango Dr Ste 120
Las Vegas, NV 89149-3941

Mailing address

138 Lomita Heights Dr
Las Vegas, NV 89138-6158

Other practice location 1

138 Lomita Heights Dr
Las Vegas, NV 89138-6158
Phone (818) 322-6528

Other identifiers 1

IdentifierTypeStateIssuer
250018538MedicaidNV

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
I20210127001774 NV Practitioner - Nurse Practitioner 9436563798 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
835711NVMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heal and Glow Wellness LLC CurrentSince Jul 1, 2025 Accepting new patients
WT Health of Nevada LLC CurrentSince Jul 12, 2025 Accepting new patients
Body and Mind Health Partners CurrentSince Aug 1, 2024 Accepting new patients

Locations

2621 W Horizon Ridge Pkwy
Ste 110
Henderson, NV 89052
Phone (702) 308-5534

2121 E Flamingo Rd
Ste 202
Las Vegas, NV 89119
Phone (702) 369-0004

6889 W Charleston Blvd
Ste A
Las Vegas, NV 89117
Phone (702) 703-5597

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326649468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 LOMITA HEIGHTS DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891386158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 N DURANGO DR STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891493941",
            "telephone_number": "954-923-7440",
            "fax_number": "954-923-1299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "138 Lomita Heights Dr",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891386158",
            "country_code": "US",
            "telephone_number": "818-322-6528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TORIBIO",
        "first_name": "MARY DENISSE",
        "credential": "NP-  NEVADA -835711",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NV",
            "license": "835711",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "835711",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NV",
            "license": "835711",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250018538",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.