Colleen Rose Raether, P.A.- C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1330 Issued in NV

Practice address

6900 N Durango Dr
Las Vegas, NV 89149-4409

Phone

(702) 835-9700

NPI assigned

Oct 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1184795874
  Medicare reassignment
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1043030919

  Physician Assistant

  NPD
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Henderson, NV
  • NPI 1487496998
  NPD
• A Better Option Healthcare Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1285155325
  NPD (past)
• Advanced House Calls Inc

  • Specialist
  • Las Vegas, NV
  • NPI 1295732451
  NPD (past)
• Doctors Medical Services, Emcare

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1578850962
  NPD (past)

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1700161031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071084",
            "telephone_number": "702-259-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 N DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494409",
            "telephone_number": "702-835-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAETHER",
        "first_name": "COLLEEN",
        "middle_name": "ROSE",
        "credential": "P.A.- C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rae Francis Kelly DC a Professional Corp
• Brittany Lynn Rae, LMSW, CSW-I
• Linda L Raebel, OTR/L
• Dolores Rael
• Raelara Tilden, LMFT Inc
• Waylon Joseph Raether
• Jenny Marie Raety, LMT-CMMP
• Delaney Grace Raetz
• Dunia Rafa
• Freddy Rafael

• 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 Mar 22, 2018; 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.