Individual provider Active NPI

Iredila Timagos Bynum, APRN FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1740044627
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
874910 Issued in NV
Practice address
6070 W Post Rd
Las Vegas, NV 89118-3419
Phone
(385) 518-0403
Fax
(385) 518-0466
NPI assigned
Feb 12, 2024
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 874910 NV
Family Nurse Practitioner 363LF0000X 874910 NV Primary
Registered Nurse 163W00000X RN74360 NV
Wound Care Registered Nurse 163WW0000X RN74360 NV

Addresses

Primary practice location

6070 W Post Rd
Las Vegas, NV 89118-3419

Mailing address

6070 W Post Rd
Las Vegas, NV 89118-3419
Phone (385) 518-0403

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
I20240614002248 NV Practitioner - Nurse Practitioner 9032652342 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN74360NVMDRegistered Nurse
874910NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Puso, LLC CurrentSince Jun 3, 2024 Accepting new patients
Calloway Health and Psych LLC CurrentSince Sep 7, 2024 Accepting new patients
Vip Wound Care Specialists PLLC CurrentSince Mar 1, 2025 Accepting new patients
Integrity Medical and Wounds LLC Wound Care CurrentSince Nov 1, 2024 Accepting new patients
702 Family Practice LLC Family Current Accepting new patients
Southwest Family Practice LLC CurrentSince Sep 8, 2024 Accepting new patients
Arlene Rillo MD Medical Group PLLC CurrentSince Jan 1, 2025 Accepting new patients
Ideal Healthcare LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

3195 Saint Rose Pkwy
Ste 212
Henderson, NV 89052
Phone (702) 342-1384

2880 Bicentennial Pkwy
Ste 100
Las Vegas, NV 89044

4760 S Pecos Rd
#10323
Las Vegas, NV 89121
Phone (213) 948-7792

5506 S Fort Apache Rd
Ste 100
Las Vegas, NV 89148
Phone (702) 360-6003

6655 S Tenaya Way
Ste 180
Las Vegas, NV 89113
Phone (702) 463-7611

801 S Rancho Dr
Ste A2
Las Vegas, NV 89106
Phone (702) 483-3630

801 S Rancho Dr
Ste B2
Las Vegas, NV 89106
Phone (702) 331-4808

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1740044627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 W POST RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183419",
            "telephone_number": "385-518-0403",
            "fax_number": "385-518-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 W POST RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183419",
            "telephone_number": "385-518-0403",
            "fax_number": "385-518-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYNUM",
        "first_name": "IREDILA",
        "middle_name": "TIMAGOS",
        "name_prefix": "Ms.",
        "credential": "APRN FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2025-02-17",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "874910",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "874910",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN74360",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NV",
            "license": "RN74360",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.