Individual provider Active NPI

Robert Allen Fares, APRN FNP

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1629774666
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
864097 Issued in NV
Practice address
6190 W Lake Mead Blvd
Las Vegas, NV 89108-2661
Phone
(725) 293-4224
Fax
(725) 293-5359
NPI assigned
Feb 1, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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 864097 NV Primary

Addresses

Primary practice location

6190 W Lake Mead Blvd
Las Vegas, NV 89108-2661

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (888) 987-1151

Other practice location 1

804 Coliseum Ln
Las Vegas, NV 89144-1244
Phone (801) 831-7340

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
I20240906002796 NV Practitioner - Nurse Practitioner 7810437688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

102 Woodmont Blvd
Suite 600
Nashville, TN 37205-5250

2460 Paseo Verde Pkwy
Suite 145
Henderson, NV 89074-7135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
864097NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Khakwani Medical Corporation, PC Current Accepting new patients
Archwell Health Professional Services of Nevada, P.C. CurrentSince Oct 9, 2025 Accepting new patients
Khakwani Medical Corporation, PC Past Accepting new patients
Khakwani Medical Corporation, PC PastSince Aug 28, 2022 Accepting new patients
Khakwani Medical Corporation, PC Past Accepting new patients
Khakwani Medical Corporation, PC Past Accepting new patients
Khakwani Medical Corporation, PC Past Accepting new patients

Locations

1135 Vitality Dr
Ste 120
Henderson, NV 89011
Phone (702) 359-7403

366 W Lake Mead Pkwy
Ste 100
Henderson, NV 89015
Phone (702) 359-5210

1501 W Sunset Rd
Henderson, NV 89014
Phone (725) 269-7001

2460 Paseo Verde Pkwy
Ste 145
Henderson, NV 89074

2231 N Green Valley Pkwy
#B
Henderson, NV 89014
Phone (702) 766-1972

6190 W Lake Mead Blvd
Las Vegas, NV 89108
Phone (725) 293-4224

10040 Alta Dr
Ste 100B
Las Vegas, NV 89145
Phone (702) 960-0689

3140 S Durango Dr
Ste 100B
Las Vegas, NV 89117
Phone (702) 273-3680

6525 N Decatur Blvd
Ste 150B
Las Vegas, NV 89131
Phone (702) 979-5903

4950 W Sahara Ave
Ste 100B
Las Vegas, NV 89146
Phone (702) 577-9773

6975 Aliante Pkwy
Ste 101B
North Las Vegas, NV 89084
Phone (702) 867-0087

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Organizations & group practices 7

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1629774666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "888-987-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6190 W LAKE MEAD BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891082661",
            "telephone_number": "725-293-4224",
            "fax_number": "725-293-5359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Coliseum Ln",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891441244",
            "country_code": "US",
            "telephone_number": "801-831-7340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARES",
        "first_name": "ROBERT",
        "middle_name": "ALLEN",
        "credential": "APRN FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-01",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "864097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.