Individual provider Active NPI

Melinda Marie Victorson, APRN-CNP

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1639754468
Registry record updated Aug 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
836430 Issued in NV
Practice address
2329 Thayer Ave
Henderson, NV 89074-5368
Phone
(702) 419-6668
NPI assigned
Mar 12, 2021
Last updated
Aug 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2024

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 836430 NV Primary

Addresses

Primary practice location

2329 Thayer Ave
Henderson, NV 89074-5368

Mailing address

2329 Thayer Ave
Henderson, NV 89074-5368
Phone (702) 419-6668

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
I20211124001790 NV Practitioner - Nurse Practitioner 6406246974 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Wound Care SpecialistGroup PAC ID 1658718093, 3 clinicians
NCC House Calls LLCGroup PAC ID 3678849296, 4 clinicians
Rhodium Medical of Nevada LLCGroup PAC ID 9335659630, 4 clinicians

Practice addresses (Care Compare)

3830 E Flamingo Rd
Suite 201
Las Vegas, NV 89121-6234
Phone (702) 659-5604

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
836430NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Express Excellence Care LLC Family CurrentSince Aug 6, 2024 Accepting new patients
Platinum Wound Care Specialist CurrentSince Nov 1, 2024 Accepting new patients
NCC House Calls LLC CurrentSince Nov 1, 2024 Accepting new patients
Craig M Jorgenson MD LTD CurrentSince Oct 1, 2024 Accepting new patients
Rhodium Medical of Arizona LLC PastSince Mar 11, 2025 Accepting new patients

Locations

1000 N Green Valley Pkwy
#440127
Henderson, NV 89074
Phone (702) 361-2273

1000 N Green Valley Pkwy
Ste 440127
Henderson, NV 89074

2325 E Harmon Ave
Las Vegas, NV 89119
Phone (702) 789-7990

3830 E Flamingo Rd
#201
Las Vegas, NV 89121
Phone (702) 600-7977

3830 E Flamingo Rd
Ste 201
Las Vegas, NV 89121
Phone (702) 659-5604

6330 S Jones Blvd
Las Vegas, NV 89118
Phone (702) 659-9090

9975 S Eastern Ave
Ste 110
Las Vegas, NV 89183
Phone (702) 361-2273

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, 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": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723852800000",
    "number": "1639754468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 THAYER AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745368",
            "telephone_number": "702-419-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 THAYER AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745368",
            "telephone_number": "702-419-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORSON",
        "first_name": "MELINDA",
        "middle_name": "MARIE",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-12",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "836430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.