Individual provider Active NPI

Cody L Pulsipher, PA-C

  • Physician Assistant
  • Pahrump, NV
National Provider Identifier
1376910273
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1653 Issued in NV
Practice address
1397 S Loop Rd
Pahrump, NV 89048-4729
Phone
(775) 727-5500
Fax
(775) 727-5696
NPI assigned
Aug 26, 2015
Last updated
Oct 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1653 NV Primary
Medical Physician Assistant 363AM0700X PA1653 NV

Addresses

Primary practice location

1397 S Loop Rd
Pahrump, NV 89048-4729

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other practice location 1

4880 Wynn Rd
Las Vegas, NV 89103-5406
Phone (702) 871-5005

Other identifiers 2

IdentifierTypeStateIssuer
PA1653OtherNVSTATE LICENSE
1376910273MedicaidNV

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151021000988 NV Practitioner - Physician Assistant 1355650995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1397 S Loop Rd
Pahrump, NV 89048-4729
Phone (775) 727-5500

4880 Wynn Rd
Las Vegas, NV 89103-5406
Phone (702) 871-5005

6355 S Buffalo Dr
Las Vegas, NV 89113-2133
Phone (702) 479-4881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1653NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Southwest Medical Associates, Inc CurrentSince Jan 25, 2016 Accepting new patients
Talbert Medical Group Past Accepting new patients

Locations

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Interoperability endpoints

  • Direct secure messaging: codypulsipher@hcpnv.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1376910273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 S LOOP RD",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890484729",
            "telephone_number": "775-727-5500",
            "fax_number": "775-727-5696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4880 Wynn Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891035406",
            "country_code": "US",
            "telephone_number": "702-871-5005",
            "fax_number": "702-871-1341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULSIPHER",
        "first_name": "CODY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-26",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1653",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1653",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA1653",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376910273",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahrump, NV

Sources for this page

Verify at the official NPI Registry.