Active NPI
Jerry Makin, D.O.
- Psychiatry Physician
- Las Vegas, NV
National Provider Identifier
1649291675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20A13945
- Practice address
- 916 W Owens Ave
Las Vegas, NV 89106-2516 - Phone
- (702) 768-7300
- NPI assigned
- Jul 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20A13945 | CA | Primary |
Addresses
Primary practice location
916 W Owens Ave
Las Vegas, NV 89106-2516
Mailing address
916 W Owens Ave
Las Vegas, NV 89106-2516
Phone (702) 768-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13945 | CA | MD | Chiropractor |
| 20A13945 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431993600000",
"number": "1649291675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 W OWENS AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891062516",
"telephone_number": "702-768-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 W OWENS AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891062516",
"telephone_number": "702-768-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKIN",
"first_name": "JERRY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-23",
"last_updated": "2015-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "20A13945",
"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 May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.