Individual provider Active NPI

Conner Grimes, APRN

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1417827460
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
846431 Issued in NV
Practice address
98 E Lake Mead Pkwy
Henderson, NV 89015-5540
Phone
(702) 483-2969
NPI assigned
Nov 6, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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 846431 NV Primary

Addresses

Primary practice location

98 E Lake Mead Pkwy
Henderson, NV 89015-5540

Mailing address

337 Isla Enclave Way
Henderson, NV 89011-5697
Phone (702) 802-1432

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
I20260120004075 NV Practitioner - Nurse Practitioner 1052898160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bamboo Family Clinic LLCGroup PAC ID 9830565498, 4 clinicians

Practice addresses (Care Compare)

98 E Lake Mead Pkwy
Suite 307
Henderson, NV 89015-6444
Phone 70248329693007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
846431NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bamboo Family Clinic LLC CurrentSince Nov 11, 2025 Accepting new patients

Locations

98 E Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 478-7836

98 E Lake Mead Pkwy
Ste 307
Henderson, NV 89015
Phone (702) 483-2969

Organizations & group practices 2

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": "1762387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1417827460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 ISLA ENCLAVE WAY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890115697",
            "telephone_number": "702-802-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 E LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890155540",
            "telephone_number": "702-483-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "CONNER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "846431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.