Individual provider Active NPI

Kayoko Dinehart, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1427328657
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
815188 Issued in NV
Practice address
6070 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5615
Phone
(702) 803-5534
Fax
(888) 977-1206
NPI assigned
Jan 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 530884 CA
Family Nurse Practitioner 363LF0000X 18617 SC
Family Nurse Practitioner 363LF0000X 18035 CA
Family Nurse Practitioner 363LF0000X 815188 NV Primary

Addresses

Primary practice location

6070 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5615

Mailing address

21 W Horizon Ridge Pkwy
Henderson, NV 89012-5307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20150903001587 SC Practitioner - Nurse Practitioner 3274774237

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
530884CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Physicians (Kumar) PLLC CurrentSince Jan 23, 2023 Accepting new patients

Locations

8425 S Eastern Ave
Las Vegas, NV 89123
Phone (702) 202-2060

Organizations & group practices 1

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": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1427328657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890125307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 S FORT APACHE RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485615",
            "telephone_number": "702-803-5534",
            "fax_number": "888-977-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINEHART",
        "first_name": "KAYOKO",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "530884",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18617",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18035",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "815188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.