Nelson Jong Kwowi

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1019811 Issued in TX

Practice address

5121 Blue Rose St
North Las Vegas, NV 89081-2678

Phone

(469) 490-1505

Fax

(469) 490-1516

NPI assigned

Apr 8, 2020

Last updated

Nov 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, TX2 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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Aubree Home Care Inc

  • Home Health Agency
  • Richardson, TX
  • NPI 1578092987

  Corporate Director

  CMS ownership

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.

• Regency Psychiatric Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Richardson, TX
  • NPI 1902540974

  NV

  Medicare reassignment NPD Authorized official
• Assurance Services LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1053804161

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Zane Medical Group LLC

  dba Zane Behavioral Services

  • Primary Care Clinic/Center
  • North Las Vegas, NV
  • NPI 1801495932
  Medicare reassignment NPD
• Regency Medical Services LLC

  • Family Nurse Practitioner
  • Richardson, TX
  • NPI 1447119375
  NPD Authorized official
• Aubree Home Care Inc

  • Home Health Agency
  • Richardson, TX
  • NPI 1578092987
  NPD
• Trydent Services LLC

  dba Dutiful Angels

  • Addiction (Substance Use Disorder) Counselor
  • Las Vegas, NV
  • NPI 1215607601
  NPD (past)

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1689203853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 LANTERN LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528768",
            "telephone_number": "325-320-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 BLUE ROSE ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890812678",
            "telephone_number": "469-490-1505",
            "fax_number": "469-490-1516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5904 Lantern Ln",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750528768",
            "country_code": "US",
            "telephone_number": "325-320-0414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWOWI",
        "first_name": "NELSON",
        "middle_name": "JONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1019811",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "888347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Marcell Kuznetsov
• Donald I Kuzyk, DPM
• KVGP Medical
• Dorothy Kviberg
• Mirabelle Kwek
• Janice Marie Kyle
• James Kyles
• Alissa La France
• Michele La France
• Cuong La, MD

• Psychiatric/Mental Health Nurse Practitioner in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.