Jordan Soper, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY0808 Issued in NV

Practice address

2460 Paseo Verde Pkwy Ste 100
Henderson, NV 89074-7136

Phone

(702) 508-9181

NPI assigned

Jun 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 29, 2019 through May 29, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Caryatid Cooperative for Nevada

  dba The Evidence Based Practice of Nevada

  • Psychologist
  • Las Vegas, NV
  • NPI 1760046411
  NPD (past)

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1477904126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 PASEO VERDE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747136",
            "telephone_number": "702-508-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 PASEO VERDE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747136",
            "telephone_number": "702-508-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOPER",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60632945",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "PY0808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Sonntag
• Anant K Sonpatki, MD
• Sonu R Bhatia MD PC
• Rajat Sood, MD
• Kultida Soontarapornchai, M.D.
• Sophy Wei Feng MD (Anthem OBGYN)
• Oscar A Soraluz, M.D.
• Braden James Sorensen, OD
• Samantha Sorgentoni, DO
• Rhea Sotto Soriano

• Psychologist in Henderson, NV
• Providers in Henderson, NV by specialty
• Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.