Kimberly Gene Bland, CPC; MFT; QMHP

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

01197 Issued in NV

Practice address

400 Shadow LN Ste 106
Las Vegas, NV 89106-4355

Phone

(702) 731-0909

NPI assigned

Nov 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDEACA

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.

• Ann M. Nichols and Associates

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1497061113
  NPD (past)
• Firstmed Health and Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Las Vegas, NV
  • NPI 1396054169
  NPD (past)

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1699956706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8936 SPANISH RIDGE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481354",
            "telephone_number": "702-731-0909",
            "fax_number": "702-826-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SHADOW LN STE 106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064355",
            "telephone_number": "702-731-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAND",
        "first_name": "KIMBERLY",
        "middle_name": "GENE",
        "credential": "CPC; MFT; QMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "394-L",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CPC 0024",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "01197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699956706",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cierra Bland
• Ellana Bland
• Holly Bland
• Jacqueline Bland
• Josh T Bland
• Sheila Bland
• Vera Evern Bland
• Julia Marie Blander, REGISTERED NURSE
• Alexa Blaney
• David Blank, M.D.

• Marriage & Family Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Marriage & Family Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.