Individual provider Active NPI

Jessica Z Kirkland Caldwell, PH.D.

  • Clinical Neuropsychologist
  • Las Vegas, NV
National Provider Identifier
1336450857
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
63010115638 Issued in MI
Practice address
888 W Bonneville Ave
Las Vegas, NV 89106-0100
Phone
(702) 483-6000
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 63010115638 MI Primary

Addresses

Primary practice location

888 W Bonneville Ave
Las Vegas, NV 89106-0100

Mailing address

888 W Bonneville Ave
Las Vegas, NV 89106-0100

Other names 1

  • Jessica Z Kirkland Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160315001587 NV Practitioner - Clinical Psychologist 2062648645 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
63010115638MIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Nevada Clinical Neuropsychologist CurrentSince Feb 18, 2016 Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Dignity Health Past Accepting new patients
Cleveland Clinic Avon Hospital Past Accepting new patients

Locations

888 W Bonneville Ave
Las Vegas, NV 89106
Phone (702) 263-9797

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1336450857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 W BONNEVILLE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891060100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W BONNEVILLE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891060100",
            "telephone_number": "702-483-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND CALDWELL",
        "first_name": "JESSICA",
        "middle_name": "Z",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "63010115638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KIRKLAND",
            "middle_name": "Z",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.