Organization Active NPI

Jerideau Family Health and Wellness PLLC

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1760391015
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
JERIDEAU FAMILY HEALTH AND WELLNESS PLLC
Practice address
800 N Rainbow Blvd Ste 208
Las Vegas, NV 89107-1193
Phone
(214) 516-4681
NPI assigned
Sep 3, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Samuel Jerideau
Title
Ceo
Phone
(214) 516-4681

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

800 N Rainbow Blvd Ste 208
Las Vegas, NV 89107-1193

Mailing address

800 N Rainbow Blvd Ste 208
Las Vegas, NV 89107-1193
Phone (214) 516-4681

NPI Registry JSON

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

{
    "created_epoch": "1788393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1760391015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD STE 208",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071193",
            "telephone_number": "214-516-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD STE 208",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071193",
            "telephone_number": "214-516-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERIDEAU FAMILY HEALTH AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "JERIDEAU",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-516-4681"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "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 Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.