Individual provider Active NPI

Jennifer Lauren Daugharthy, MD

  • Emergency Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1639331630
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13239 Issued in NV
Practice address
2620 Regatta Dr Ste 102
Las Vegas, NV 89128-6892
Phone
(310) 702-5528
NPI assigned
Jun 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 13239 NV Primary

Addresses

Primary practice location

2620 Regatta Dr Ste 102
Las Vegas, NV 89128-6892

Mailing address

2620 Regatta Dr Ste 102
Las Vegas, NV 89128-6892
Phone (310) 702-5528

Other practice location 1

9300 W Sunset Rd
Las Vegas, NV 89148-4844
Phone (972) 915-3600

Other identifiers 2

IdentifierTypeStateIssuer
CS18202OtherNVPHARMACY/CONTROLLED SUBSTANCE CERTIFICATE
13239OtherNVNV MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091102000163 NV Practitioner - Emergency Medicine 7719050707 Reassigns benefits to 2 organizations
I20151117002653 WA Practitioner - Emergency Medicine 7719050707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (954) 939-5000

9300 W Sunset Rd
Las Vegas, NV 89148-4844
Phone (702) 880-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13239NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Emergency Services Scherr LTD Emergency Medicine Current Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine CurrentSince Sep 1, 2009 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine CurrentSince Sep 1, 2009 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

3325 S Fort Apache Rd
Las Vegas, NV 89117
Phone (702) 962-0500

9075 Blue Diamond Rd
Las Vegas, NV 89178
Phone (702) 916-5000

9300 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 880-2100

3186 S Maryland Pkwy
Ste 410
Las Vegas, NV 89109

9860 W Skye Cyn Dr
Las Vegas, NV 89166

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

10770 Las Vegas Blvd S
Las Vegas, NV 89183
Phone (702) 916-9002

7207 Aliante Pkwy
North Las Vegas, NV 89084
Phone (702) 962-5100

Organizations & group practices 6

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1639331630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 REGATTA DR STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286892",
            "telephone_number": "310-702-5528",
            "fax_number": "702-710-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 REGATTA DR STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286892",
            "telephone_number": "310-702-5528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 W Sunset Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891484844",
            "country_code": "US",
            "telephone_number": "972-915-3600",
            "fax_number": "972-915-3636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAUGHARTHY",
        "first_name": "JENNIFER",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "13239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY/CONTROLLED SUBSTANCE CERTIFICATE",
            "identifier": "CS18202",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV MEDICAL LICENSE",
            "identifier": "13239",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.