Individual provider Active NPI

Connie Marie Santiago, FNP-C

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1609412725
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
826173 Issued in NV
Practice address
1552 W Warm Springs Rd Ste 100
Henderson, NV 89014-4328
Phone
(702) 933-5544
NPI assigned
Nov 24, 2019
Last updated
Oct 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 826173 NV Primary

Addresses

Primary practice location

1552 W Warm Springs Rd Ste 100
Henderson, NV 89014-4328

Mailing address

1552 W Warm Springs Rd Ste 100
Henderson, NV 89014-4328
Phone (702) 933-5544

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
I20200225001333 NV Practitioner - Nurse Practitioner 8527495324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Albion Medical Group of Nevada, PCGroup PAC ID 4183891294, 23 clinicians

Practice addresses (Care Compare)

3041 E Flamingo Rd
Suite a
Las Vegas, NV 89121-7447
Phone (702) 436-0835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Toledo DO LTD CurrentSince Jan 8, 2020 Accepting new patients
Albion Medical Group of Nevada, PC CurrentSince Feb 5, 2024 Accepting new patients
Dignity Health PastSince Jan 8, 2020 Accepting new patients
Physicians Medical Center Kaufman, LTD Past Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 220
Henderson, NV 89074
Phone (702) 944-3627

1552 W Warm Springs Rd
Ste 100
Henderson, NV 89014
Phone (702) 515-9917

2598 Windmill Pkwy
Ste 110
Henderson, NV 89074
Phone (702) 933-5544

3041 E Flamingo Rd
Ste A
Las Vegas, NV 89121
Phone (702) 436-0835

Interoperability endpoints

  • Direct secure messaging: connie.santiago.1@32527.direct.athenahealth.com
  • Direct secure messaging: connie.santiago.p5@direct.caremorewest.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1574553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1609412725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 W WARM SPRINGS RD STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890144328",
            "telephone_number": "702-933-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 W WARM SPRINGS RD STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890144328",
            "telephone_number": "702-933-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "CONNIE MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-24",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "826173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.