Dallin Stephen Ralph Johnson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

833966 Issued in NV

Practice address

6600 W Charleston Blvd Ste 142
Las Vegas, NV 89146-1050

Phone

(702) 440-8430

Fax

(866) 640-0525

NPI assigned

Aug 13, 2024

Sex

Male

Sole proprietor

Yes

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stark Medicine McKay Khurana Jeider PLLCGroup PAC ID 1557601978, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Stark Medicine McKay Khurana Jeider PLLC

  • Child & Adolescent Psychiatry Physician
  • Las Vegas, NV
  • NPI 1053880856
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1730910415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 W CHARLESTON BLVD STE 142",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461050",
            "telephone_number": "702-440-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 W CHARLESTON BLVD STE 142",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461050",
            "telephone_number": "702-440-8430",
            "fax_number": "866-640-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DALLIN",
        "middle_name": "STEPHEN RALPH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NV",
            "license": "833966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudette Denise Johnson
• Colin Johnson
• Crishon Aaron Johnson
• Cristopher Johnson, PTA
• Cupid Johnson
• Dameshion Johnson
• Damian Johnson
• Dana Johnson
• Dana Johnson
• Daniel Edward Johnson

• Psychiatric/Mental Health Clinical Nurse Specialist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.
• 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.