Individual provider Active NPI

Jessica Tan, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1417480310
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002480 Issued in NV
Practice address
2035 W Charleston Blvd
Las Vegas, NV 89102-2223
Phone
(702) 304-2144
NPI assigned
Apr 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN002480 NV Primary

Addresses

Primary practice location

2035 W Charleston Blvd
Las Vegas, NV 89102-2223

Mailing address

5575 Simmons St
Unit 1 #563
North Las Vegas, NV 89031-9008
Phone (702) 304-2144

Other names 1

  • Jessica Wright Former name

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
I20170727002846 NV Practitioner - Nurse Practitioner 9638449358 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NV Pacs 2 LLCGroup PAC ID 0941550578, 119 clinicians
Nevada Post-Acute Medical Services-Scherr 1 P.CGroup PAC ID 7012292634, 18 clinicians

Practice addresses (Care Compare)

2325 E Harmon Ave
Las Vegas, NV 89119-7848
Phone (702) 798-7990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN002480NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 West LLC CurrentSince Sep 9, 2024 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Feb 10, 2021 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Feb 10, 2021 Accepting new patients
NV Pacs 2 LLC CurrentSince Aug 8, 2024 Accepting new patients

Locations

2325 E Harmon Ave
Las Vegas, NV 89119
Phone (702) 798-1990

4015 McLeod Dr
Las Vegas, NV 89121
Phone (702) 433-2200

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2716 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 240-8934

2716 N Tenaya Way
Fl 2
Las Vegas, NV 89128
Phone (702) 579-3296

1701 S Torrey Pines Dr
Las Vegas, NV 89146
Phone (702) 515-6200

2860 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 233-0684

10550 Park Run Dr
Las Vegas, NV 89144
Phone (702) 515-6200

2035 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 386-7980

6351 N Fort Apache Rd
Las Vegas, NV 89149
Phone (702) 395-1555

1250 S Valley View Blvd
Las Vegas, NV 89102
Phone (702) 259-3570

Organizations & group practices 6

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": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1417480310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 SIMMONS ST",
            "address_2": "UNIT 1 #563",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890319008",
            "telephone_number": "702-304-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022223",
            "telephone_number": "702-304-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "JESSICA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WRIGHT",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.