Organization Active NPI

Full Circle Care PLLC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1336835404
Registry record updated Apr 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
FULL CIRCLE CARE PLLC
Doing business as
Full Circle Care
Practice address
2110 E Flamingo Rd Ste 105
Las Vegas, NV 89119-5191
Phone
(702) 695-2084
Fax
(702) 537-0981
NPI assigned
Apr 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2024

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

Authorized official

Name
Mrs. Jennifer Elizabeth Story-Salacup, APRNNPI 1801263868
Title
Nurse Practitioner
Phone
(702) 513-5533

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

2110 E Flamingo Rd Ste 105
Las Vegas, NV 89119-5191

Mailing address

2110 E Flamingo Rd Ste 105
Las Vegas, NV 89119-5191
Phone (702) 695-2084

Other names 1

  • Full Circle Care Doing business as

National Provider Directory

National Provider Directory

Locations

2110 E Flamingo Rd
Ste 105
Las Vegas, NV 89119
Phone (702) 695-2084

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713571200000",
    "number": "1336835404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 E FLAMINGO RD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195191",
            "telephone_number": "702-695-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E FLAMINGO RD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195191",
            "telephone_number": "702-695-2084",
            "fax_number": "702-537-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CIRCLE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-12",
        "last_updated": "2024-04-20",
        "certification_date": "2024-04-20",
        "status": "A",
        "authorized_official_last_name": "STORY-SALACUP",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "702-513-5533",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Full Circle Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Full Circle Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.