Individual provider Active NPI

Kelsey Larrayne McPheeters, FNP-C

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1639758501
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
868206 Issued in NV
Practice address
2845 Siena Heights Dr Ste 1100
Henderson, NV 89052-4161
Phone
(702) 877-5199
NPI assigned
Apr 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP023557 PA
Family Nurse Practitioner 363LF0000X 868206 NV Primary

Addresses

Primary practice location

2845 Siena Heights Dr Ste 1100
Henderson, NV 89052-4161

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 838-8265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220504002342 PA Practitioner - Nurse Practitioner 8325435639 Reassigns benefits to 1 organization
I20230815001131 NV Practitioner - Nurse Practitioner 8325435639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Jefferson Medical College of Thomas Jefferson University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

888 S Rancho Dr
Las Vegas, NV 89106-3810
Phone (702) 579-3253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
868206NVMDFamily Nurse Practitioner
SP023557PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C CurrentSince Sep 1, 2023 Accepting new patients
Main Line Healthcare CurrentSince Jan 26, 2022 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Sep 1, 2023 Accepting new patients
Southwest Medical Associates, Inc PastSince Dec 22, 2024 Accepting new patients

Locations

2845 Siena Heights Dr
Ste 1100
Henderson, NV 89052
Phone (702) 669-5840

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

4475 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 669-5811

888 S Rancho Dr
Las Vegas, NV 89106
Phone (702) 877-5375

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1020 Baltimore Pike
Ste 100
Glen Mills, PA 19342
Phone (484) 227-7790

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

Interoperability endpoints

  • Direct secure messaging: kmcpheeters120789@westdirect.optum.com

Organizations & group practices 4

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1639758501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-838-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 SIENA HEIGHTS DR STE 1100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524161",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPHEETERS",
        "first_name": "KELSEY",
        "middle_name": "LARRAYNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023557",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "868206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.