Individual provider Active NPI

Kelly Yovanno Twells, APRN

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1710395496
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN001783 Issued in NV
Practice address
390 W Lake Mead Pkwy Ste 120
Henderson, NV 89015-7417
Phone
(252) 208-4777
Fax
(833) 749-0360
NPI assigned
Jul 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN001783 NV Primary

Addresses

Primary practice location

390 W Lake Mead Pkwy Ste 120
Henderson, NV 89015-7417

Mailing address

390 W Lake Mead Pkwy Ste 120
Henderson, NV 89015-7417
Phone (725) 220-8477

Other identifiers 2

IdentifierTypeStateIssuer
1710395496MedicaidNV
V74329OtherNVMEDICARE

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
I20140818001046 NV Practitioner - Nurse Practitioner 6305063298 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc CurrentSince Feb 20, 2017 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Jun 3, 2019 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Jun 3, 2019 Accepting new patients
Family Home Hospice, Inc. CurrentSince Mar 1, 2021 Accepting new patients

Locations

8655 S Eastern Ave
Las Vegas, NV 89123
Phone (702) 468-8662

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

Organizations & group practices 4

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": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1710395496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 W LAKE MEAD PKWY STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157417",
            "telephone_number": "725-220-8477",
            "fax_number": "833-749-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 W LAKE MEAD PKWY STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157417",
            "telephone_number": "252-208-4777",
            "fax_number": "833-749-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWELLS",
        "first_name": "KELLY",
        "middle_name": "YOVANNO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710395496",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "V74329",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.