Individual provider Active NPI

Chalisa Pansin

  • Acute Care Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1619627213
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
847083 Issued in NV
Practice address
3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone
(702) 961-5000
NPI assigned
Mar 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 175033 CT
Registered Nurse 163W00000X 847083 NV
Acute Care Nurse Practitioner 363LA2100X 847083 NV Primary

Addresses

Primary practice location

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317

Mailing address

PO Box 100744
Atlanta, GA 30384-0744

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
I20221018003116 NV Practitioner - Nurse Practitioner 2567838493 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175033CTMDRegistered Nurse
847083NVMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan LLC CurrentSince Nov 10, 2024 Accepting new patients

Locations

3201 S Maryland Pkwy
Ste 314
Las Vegas, NV 89109
Phone (702) 796-8500

Interoperability endpoints

  • Direct secure messaging: chalisa.pansin.1@20265.direct.athenahealth.com

Organizations & group practices 1

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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1619627213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100744",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092317",
            "telephone_number": "702-961-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANSIN",
        "first_name": "CHALISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "175033",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "847083",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NV",
            "license": "847083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.