Individual provider Active NPI

Kayle Rayne Haderlie

  • Certified Registered Nurse Anesthetist
  • Las Vegas, NV
National Provider Identifier
1710583141
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
835624 Issued in NV
Practice address
6900 N Durango Dr
Las Vegas, NV 89149-4409
Phone
(702) 835-9700
NPI assigned
Dec 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 835624 NV
Certified Registered Nurse Anesthetist 367500000X 835624 NV Primary

Addresses

Primary practice location

6900 N Durango Dr
Las Vegas, NV 89149-4409

Mailing address

1100 Turtle Creek Dr Apt 214
Naples, FL 34110-2200
Phone (702) 606-3224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210201000369 NV Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537573670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Anesthesiology Consultants-Beckett-PLLCGroup PAC ID 6507925849, 42 clinicians

Practice addresses (Care Compare)

2565 E Flamingo Rd
Las Vegas, NV 89121-5203
Phone (702) 697-7900

8656 W Patrick LN
Las Vegas, NV 89148-5043
Phone (702) 777-7100

9300 W Sunset Rd
Las Vegas, NV 89148-4844
Phone (702) 880-2100

Hospital & facility affiliations

  • Southern Hills Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290047
  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
835624NVMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Anesthesiology Consultants-Beckett-PLLC CurrentSince Jan 6, 2021 Accepting new patients

Locations

10120 S Eastern Ave
Ste 100
Henderson, NV 89052
Phone (702) 487-6880

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

2565 E Flamingo Rd
Las Vegas, NV 89121
Phone (702) 697-7900

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1710583141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 TURTLE CREEK DR APT 214",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341102200",
            "telephone_number": "702-606-3224"
        },
        {
            "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": "HADERLIE",
        "first_name": "KAYLE",
        "middle_name": "RAYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NV",
            "license": "835624",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NV",
            "license": "835624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.