Individual provider Active NPI

Michelle Jensen, RD, CDE

  • Registered Dietitian
  • Las Vegas, NV
National Provider Identifier
1699174706
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
32302DI-0 Issued in NV
Practice address
6040 S Fort Apache Rd
Suite 100
Las Vegas, NV 89148
Phone
(702) 475-4007
Fax
(702) 475-4060
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 32302DI-0 NV Primary

Addresses

Primary practice location

6040 S Fort Apache Rd
Suite 100
Las Vegas, NV 89148

Mailing address

6040 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5613
Phone (702) 475-4007

Other practice location 1

3277 E Warm Springs Rd Ste 300
Las Vegas, NV 89120-3176
Phone (702) 475-4007

Other practice location 2

6040 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5613
Phone (702) 475-4007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813011597 NV Practitioner - Registered Dietitian Or Nutrition Professional 1658686050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MK-RdnutritionGroup PAC ID 1951679893, 6 clinicians

Practice addresses (Care Compare)

6040 S Fort Apache
Suite 100
Las Vegas, NV 89148-5613

6040 S Fort Apache Rd
Suite 100
Las Vegas, NV 89148-5613
Phone (702) 475-4007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32302DI-0NVMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Center of Southern Nevada Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients

Organizations & group practices 6

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1699174706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 S FORT APACHE RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485613",
            "telephone_number": "702-475-4007",
            "fax_number": "702-475-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 S FORT APACHE RD",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89148",
            "telephone_number": "702-475-4007",
            "fax_number": "702-475-4060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3277 E Warm Springs Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891203176",
            "country_code": "US",
            "telephone_number": "702-475-4007",
            "fax_number": "702-475-4060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6040 S Fort Apache Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891485613",
            "country_code": "US",
            "telephone_number": "702-475-4007",
            "fax_number": "702-475-4060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MICHELLE",
        "credential": "RD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NV",
            "license": "32302DI-0",
            "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 Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.