NPIMap

Organization Active NPI

Lisa a Durette MD PLLC

Doing business as Healthy Minds

  • Psychologist
  • Las Vegas, NV
National Provider Identifier
1639727365
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
LISA A DURETTE MD PLLC
Doing business as
Healthy Minds
Practice address
526 S Tonopah Dr Ste 200
Las Vegas, NV 89106-4013
Phone
(702) 440-8440
NPI assigned
Aug 27, 2019
Last updated
Nov 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
LISA A DURETTE MD PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Authorized official

Name
Kenneth McKay, PH.D.
Title
Ceo
Phone
(702) 419-8920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

526 S Tonopah Dr Ste 200
Las Vegas, NV 89106-4013

Mailing address

PO Box 82038
Las Vegas, NV 89180-2038
Phone (702) 359-9899

Other names 1

  • Healthy Minds Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lisa a Durette MD LLC5 organizations share this tax ID, including this one
Part of
Lisa a Durette MD LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

526 S Tonopah Dr
Las Vegas, NV 89106
Phone (702) 440-8440

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1639727365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82038",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891802038",
            "telephone_number": "702-359-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 S TONOPAH DR STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064013",
            "telephone_number": "702-440-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA A DURETTE MD PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LISA A DURETTE MD PLLC",
        "enumeration_date": "2019-08-27",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "MCKAY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-419-8920",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Minds",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthy Minds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 21, 2022; 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.