Individual provider Active NPI

Irishanne G Venditto, FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1437787728
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
829701 Issued in NV
Practice address
5701 W Charleston Blvd Ste 100
Las Vegas, NV 89146-1256
Phone
(702) 301-4798
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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 829701 NV Primary

Addresses

Primary practice location

5701 W Charleston Blvd Ste 100
Las Vegas, NV 89146-1256

Mailing address

5701 W Charleston Blvd Ste 100
Las Vegas, NV 89146-1256
Phone (702) 877-9514

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
I20200804000567 NV Practitioner - Nurse Practitioner 1456776749 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Valley Surgery Center, LLC CurrentSince Mar 12, 2022 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Sep 1, 2022 Accepting new patients
Rd Prabhu-Lata K Shete MDS LTD CurrentSince Oct 1, 2020 Accepting new patients
Rd Prabhu-Lata K Shete MDS LTD CurrentSince Oct 1, 2020 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Sep 1, 2022 Accepting new patients
Southwest Medical Associates, Inc Past Accepting new patients
Comprehensive Urgent Care Past Accepting new patients

Locations

3835 S Jones Blvd
Ste 103
Las Vegas, NV 89103
Phone (702) 227-4440

5820 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 737-1880

5701 W Charleston Blvd
Ste 100
Las Vegas, NV 89146
Phone (702) 877-9514

3835 S Jones Blvd
Ste 104
Las Vegas, NV 89103
Phone 7028804193750

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

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

Interoperability endpoints

  • Direct secure messaging: ivenditto120757@westdirect.optum.com

Organizations & group practices 7

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1437787728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461256",
            "telephone_number": "702-877-9514",
            "fax_number": "702-312-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461256",
            "telephone_number": "702-301-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDITTO",
        "first_name": "IRISHANNE",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "829701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.