NPIMap

Organization Active NPI

Phenomenal Mama Limited Liability Company

  • Doula
  • Las Vegas, NV
National Provider Identifier
1629958228
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Legal business name
PHENOMENAL MAMA LIMITED LIABILITY COMPANY
Practice address
5792 Ireland Ridge CT
Las Vegas, NV 89149-1281
Phone
(702) 419-4055
NPI assigned
Sep 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Tiara FlynnNPI 1619868627
Title
Founder/Owner
Phone
(702) 419-4055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DoulaGroup: 193400000X SINGLE SPECIALTY GROUP 374J00000X Primary

Addresses

Primary practice location

5792 Ireland Ridge CT
Las Vegas, NV 89149-1281

Mailing address

5792 Ireland Ridge CT
Las Vegas, NV 89149-1281
Phone (702) 419-4055

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1629958228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5792 IRELAND RIDGE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891491281",
            "telephone_number": "702-419-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5792 IRELAND RIDGE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891491281",
            "telephone_number": "702-419-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHENOMENAL MAMA LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "TIARA",
        "authorized_official_title_or_position": "FOUNDER/OWNER",
        "authorized_official_telephone_number": "702-419-4055"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 4, 2025; 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.