Individual provider Active NPI

Lucy Kennington

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1699504142
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
832750 Issued in NV
Practice address
6161 W Charleston Blvd
Las Vegas, NV 89146-1126
Phone
(702) 486-6000
NPI assigned
Jul 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 832750 NV Primary

Addresses

Primary practice location

6161 W Charleston Blvd
Las Vegas, NV 89146-1126

Mailing address

9136 Worsley Park PL
Las Vegas, NV 89145-8711
Phone (601) 951-2558

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
I20241121004133 NV Practitioner - Nurse Practitioner 1759816168 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Nevada Current Accepting new patients
State of Nevada CurrentSince Sep 16, 2024 Accepting new patients
Southern Nevada Adult Mental Health CurrentSince Sep 16, 2024 Accepting new patients

Locations

4150 Technology Way
Ste 100
Carson City, NV 89706

1909 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 471-0420

6161 W Charleston Blvd
Las Vegas, NV 89146
Phone (702) 486-4400

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": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1699504142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9136 WORSLEY PARK PL",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891458711",
            "telephone_number": "601-951-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461126",
            "telephone_number": "702-486-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNINGTON",
        "first_name": "LUCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "832750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.