Individual provider Active NPI

Jaquin Larine Fielder, LPN

  • Licensed Practical Nurse
  • Las Vegas, NV
National Provider Identifier
1609404623
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN17257 Issued in NV
Practice address
6849 W Charleston Blvd Ste B
Las Vegas, NV 89117-1649
Phone
(702) 980-2544
NPI assigned
Mar 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN17257 NV Primary

Addresses

Primary practice location

6849 W Charleston Blvd Ste B
Las Vegas, NV 89117-1649

Mailing address

1861 Pear Hatpin CT
Las Vegas, NV 89106
Phone (702) 980-2544

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL FIELDERJAQUIN@GMAIL.COM Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN17257NVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1609404623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 PEAR HATPIN CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "telephone_number": "702-980-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6849 W CHARLESTON BLVD STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171649",
            "telephone_number": "702-980-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDER",
        "first_name": "JAQUIN",
        "middle_name": "LARINE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NV",
            "license": "LPN17257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "FIELDERJAQUIN@GMAIL.COM",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6849 W Charleston Blvd Ste B",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891171649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 27, 2020; 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.