Individual provider Active NPI

Ernest Paul Tinnin Jr.

  • Case Manager/Care Coordinator
  • Las Vegas, NV
National Provider Identifier
1366743023
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
3440 E Russell Rd # 211
Las Vegas, NV 89120-2201
Phone
(702) 646-5437
Fax
(702) 396-4193
NPI assigned
Nov 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

3440 E Russell Rd # 211
Las Vegas, NV 89120-2201

Mailing address

3440 E Russell Rd # 211
Las Vegas, NV 89120-2201
Phone (702) 960-5484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
One for All LLC CurrentSince Jan 19, 2020 Accepting new patients
One for All NV Current Accepting new patients
Eagle Quest of Nevada Past Accepting new patients

Locations

3440 E Russell Rd
#211
Las Vegas, NV 89120
Phone (702) 214-4254

Organizations & group practices 3

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": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1366743023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 E RUSSELL RD # 211",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891202201",
            "telephone_number": "702-960-5484",
            "fax_number": "702-214-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 E RUSSELL RD # 211",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891202201",
            "telephone_number": "702-646-5437",
            "fax_number": "702-396-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINNIN",
        "first_name": "ERNEST",
        "middle_name": "PAUL",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-11",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 16, 2020; 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.