Kyle Anderson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2376 Issued in NV

Practice address

9010 W Cheyenne Ave
Las Vegas, NV 89129-8932

Phone

(702) 240-8646

NPI assigned

Feb 13, 2021

Last updated

Feb 6, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV, UT2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Dana Forte D O LTDGroup PAC ID 1254239387, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Delta Community Hospital Hospital, Delta, UT, CCN 461300

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Provo, UT
  • NPI 1093764805
  Medicare reassignment Care Compare group NPD
• Dana Forte D O LTD

  dba Forte Family Practice

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1649209420
  Medicare reassignment Care Compare group
• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services, Inc.

  dba Intermountain Health Delta Community Hospital

  • Critical Access Hospital
  • Delta, UT
  • NPI 1962504068
  Care Compare affiliation

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

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1508459231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9010 W CHEYENNE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298932",
            "telephone_number": "702-240-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9010 W CHEYENNE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298932",
            "telephone_number": "702-240-8646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 White Sage Ave",
            "address_purpose": "LOCATION",
            "city": "Delta",
            "state": "UT",
            "postal_code": "846248928",
            "country_code": "US",
            "telephone_number": "435-864-3333",
            "fax_number": "435-864-2790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KYLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-13",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14267947-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.fortefamilypractice.com",
            "affiliation": "N",
            "address_1": "9010 W Cheyenne Ave",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891298932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kesean Mishae Anderson
• Kierra Anderson
• Kimberley Nicole Anderson
• Kristen E Anderson, APRN
• Kristine Angel Anderson
• Laritta Devine Anderson
• Latasha Anderson
• Latoya Marie Anderson
• Latriana Anderson
• Laura Beth Anderson

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.