Individual provider Active NPI

Jennica Jimenez

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1689422891
Registry record updated May 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
878334 Issued in NV
Practice address
5776 Mia Skye St
Las Vegas, NV 89148-5353
Phone
(702) 635-2592
NPI assigned
May 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 878334 NV Primary

Addresses

Primary practice location

5776 Mia Skye St
Las Vegas, NV 89148-5353

Mailing address

5776 Mia Skye St
Las Vegas, NV 89148-5353
Phone (702) 635-2592

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
I20250923004602 NV Practitioner - Nurse Practitioner 5698281061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
JPNP LLCGroup PAC ID 0547776916, 2 clinicians

Practice addresses (Care Compare)

2915 W Charleston Blvd
Suite 180
Las Vegas, NV 89102-1903
Phone (702) 258-4469

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
JPNP, LLC Family CurrentSince May 5, 2025 Accepting new patients

Locations

2915 W Charleston Blvd
Ste 180
Las Vegas, NV 89102
Phone (702) 258-4469

Organizations & group practices 1

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": "1715385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715385600000",
    "number": "1689422891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5776 MIA SKYE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485353",
            "telephone_number": "702-635-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5776 MIA SKYE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485353",
            "telephone_number": "702-635-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "JENNICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-11",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "878334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.