Individual provider Active NPI

Brezya Jasmine Nicole Rhodes, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1497282016
Registry record updated Aug 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1839 Issued in NV
Practice address
500 N Rainbow Blvd Ste 203
Las Vegas, NV 89107-1084
Phone
(702) 259-1228
NPI assigned
May 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X PA1839 NV
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA1839 NV Primary

Addresses

Primary practice location

500 N Rainbow Blvd Ste 203
Las Vegas, NV 89107-1084

Mailing address

500 N Rainbow Blvd Ste 203
Las Vegas, NV 89107-1084

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
I20170712000949 NV Practitioner - Physician Assistant 4183993843 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1839NVMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC Physician Assistant CurrentSince Jun 1, 2017 Accepting new patients
Shadow Emergency Physicians PLLC Physician Assistant CurrentSince Jun 1, 2017 Accepting new patients
Doctors Medical Services, Emcare General Acute Care Hospital Past Accepting new patients

Locations

1050 W Galleria Dr
Henderson, NV 89011
Phone (702) 723-4124

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

Organizations & group practices 3

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": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1497282016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071084",
            "telephone_number": "702-259-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODES",
        "first_name": "BREZYA",
        "middle_name": "JASMINE NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NV",
            "license": "PA1839",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.