Individual provider Active NPI

Kody Brett Allard, NP-C

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1699376558
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
835597 Issued in NV
Practice address
4424 S Eastern Ave
Las Vegas, NV 89119-7825
Phone
(702) 732-7440
NPI assigned
Nov 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 835597 NV Primary

Addresses

Primary practice location

4424 S Eastern Ave
Las Vegas, NV 89119-7825

Mailing address

4424 S Eastern Ave
Las Vegas, NV 89119-7825
Phone (702) 732-7440

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
I20221026001012 NV Practitioner - Nurse Practitioner 7315313749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.64 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
63.66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
835597NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Antonio Serru Paez MD Professional Corporation Nurse Practitioner CurrentSince Mar 10, 2024 Accepting new patients
True North Health Navigation LLC Past Accepting new patients
Infinity Hospice Care LLC Past Accepting new patients

Locations

4424 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 550-6868

4418 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 732-7440

Interoperability endpoints

  • Direct secure messaging: kody.allard.1@15442.direct.athenahealth.com

Organizations & group practices 3

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": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1699376558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197825",
            "telephone_number": "702-732-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197825",
            "telephone_number": "702-732-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLARD",
        "first_name": "KODY",
        "middle_name": "BRETT",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-05",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "835597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.