McKell Kellogg Prince

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2909 Issued in NV

Practice address

5320 S Rainbow Blvd Ste 250
Las Vegas, NV 89118-1807

Phone

(702) 671-6480

Fax

(702) 671-6481

NPI assigned

Jul 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• McKell Kellogg Former name

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yee Advanced Orthopedics and Sports Medicine PCGroup PAC ID 8921042276, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern Hills Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Yee Advanced Orthopedics and Sports Medicine PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Las Vegas, NV
  • NPI 1114029287
  Medicare reassignment Care Compare group NPD
• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southern Hills Medical Center, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1457306359
  Care Compare affiliation

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1699401968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-780-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD STE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181807",
            "telephone_number": "702-671-6480",
            "fax_number": "702-671-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "MCKELL",
        "middle_name": "KELLOGG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-28",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKELL",
            "last_name": "KELLOGG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey Darin Prince, DC
• Jeremy Dontia Prince
• Journee Prince
• Kayla Prince
• Kevin Darrell Prince, M.D.
• Nichole Prince
• Patricia Prince, MD
• Ruby Prince
• Schatoya Rene Prince
• Tamara Prince

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.