Individual provider Active NPI

Latoya Renee Matthews, APRN, FNP

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1649806050
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
829693 Issued in NV
Practice address
7201 W Lake Mead Blvd Ste 112
Las Vegas, NV 89128-8362
Phone
(702) 703-5160
Fax
(702) 946-5052
NPI assigned
Mar 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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 95014209 CA
Family Nurse Practitioner 363LF0000X 829693 NV Primary

Addresses

Primary practice location

7201 W Lake Mead Blvd Ste 112
Las Vegas, NV 89128-8362

Mailing address

4179 S Riverboat Rd Ste 220
Salt Lake City, UT 84123-2986
Phone (801) 921-6816

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
I20240126002770 NV Practitioner - Nurse Practitioner 1850710773 Practice locations: Henderson, NV

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95014209CAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: lmatthews1259432@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1649806050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4179 S RIVERBOAT RD STE 220",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841232986",
            "telephone_number": "801-921-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 W LAKE MEAD BLVD STE 112",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891288362",
            "telephone_number": "702-703-5160",
            "fax_number": "702-946-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "LATOYA",
        "middle_name": "RENEE",
        "credential": "APRN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014209",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "829693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.