Organization Active NPI

Mobile Health PLLC

  • Health Service Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1689306573
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
MOBILE HEALTH PLLC
Practice address
10409 Pacific Palisades Ave
Las Vegas, NV 89144-1221
Phone
(661) 405-4315
NPI assigned
Jun 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Authorized official

Name
Dr. Jacqueline Palmer
Title
FNP-C
Phone
(404) 447-4007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

10409 Pacific Palisades Ave
Las Vegas, NV 89144-1221

Mailing address

45465 25TH St E SPC 168
Lancaster, CA 93535-2392

Other identifiers 1

IdentifierTypeStateIssuer
1689167751MedicaidCA

National Provider Directory

National Provider Directory

Locations

2626 S Rainbow Blvd
Ste 101
Las Vegas, NV 89146
Phone (404) 447-4007

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1689306573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45465 25TH ST E SPC 168",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935352392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10409 PACIFIC PALISADES AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891441221",
            "telephone_number": "661-405-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "FNP-C",
        "authorized_official_telephone_number": "404-447-4007",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689167751",
            "state": "CA"
        }
    ],
    "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 Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.