Judith Cherotich Leitich, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

824865 Issued in NV

Practice address

2820 W Charleston Blvd Ste 38
Las Vegas, NV 89102-1934

Phone

(725) 895-9300

NPI assigned

Feb 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Eterne Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
  • NPI 1780356626

  Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1346832110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2954 MAJESTIC HEIGHTS CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89117",
            "telephone_number": "415-200-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 W CHARLESTON BLVD STE 38",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021934",
            "telephone_number": "725-895-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITICH",
        "first_name": "JUDITH",
        "middle_name": "CHEROTICH",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "824865",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "824865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Leininger
• Shannon D Leininger, MED, RD, LD, CDE
• Marc Leiserowitz, MD
• Sarah Leiserowitz
• Cheryl Leisinger-Fletcher
• Marc Jay Leitner, M.D.
• Maria Teresa Leiva Avila
• Karla J Leiva
• Kelly Dennise Leiva
• Matthew Alexander Leiva

• Psychiatric/Mental Health Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.