NPIMap

Organization Active NPI

JD Medical Group, LLC

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1376307058
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
JD MEDICAL GROUP, LLC
Practice address
3044 Ocean Port Dr
Las Vegas, NV 89117-0210
Phone
(702) 606-1161
NPI assigned
Feb 12, 2024
Last updated
Feb 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Maria Jill Alfonso, APRN, FNP-BCNPI 1982332227
Title
Nurse Practitioner
Phone
(702) 606-1161

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

3044 Ocean Port Dr
Las Vegas, NV 89117-0210

Mailing address

3044 Ocean Port Dr
Las Vegas, NV 89117-0210
Phone (702) 606-1161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240228002869 NV Part B Supplier - Clinic/Group Practice 2668817750 Receives reassigned benefits from 11 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

3601 W Sahara Ave
Las Vegas, NV 89102

3601 W Sahara Ave
Ste 211
Las Vegas, NV 89102
Phone (702) 606-1161

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1376307058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 OCEAN PORT DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891170210",
            "telephone_number": "702-606-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 OCEAN PORT DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891170210",
            "telephone_number": "702-606-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JD MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "ALFONSO",
        "authorized_official_first_name": "MARIA JILL",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "702-606-1161",
        "authorized_official_credential": "APRN, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "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 Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.