Organization Active NPI

Magens Bay Consulting L.L.C

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1487247391
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MAGENS BAY CONSULTING L.L.C
Practice address
2620 Regatta Dr Ste 102
Las Vegas, NV 89128-6892
Phone
(702) 751-2408
NPI assigned
Feb 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Authorized official

Name
Dr. Jacqueline Wade
Title
Director
Phone
(702) 751-2408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2620 Regatta Dr Ste 102
Las Vegas, NV 89128-6892

Mailing address

2620 Regatta Dr Ste 102
Las Vegas, NV 89128-6892
Phone (702) 751-2408

Other identifiers 1

IdentifierTypeStateIssuer
1487247391MedicaidNV

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1487247391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 REGATTA DR STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286892",
            "telephone_number": "702-751-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 REGATTA DR STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286892",
            "telephone_number": "702-751-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGENS BAY CONSULTING L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-751-2408",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487247391",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.