Individual provider Active NPI

Mahdika Keyonna Brown, DO

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Las Vegas, NV
National Provider Identifier
1770042079
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
DO3245 Issued in NV
Practice address
657 N Town Center Dr
Las Vegas, NV 89144-6367
Phone
(702) 233-7000
NPI assigned
Mar 16, 2019
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO3245 NV
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X DO3245 NV Primary

Addresses

Primary practice location

657 N Town Center Dr
Las Vegas, NV 89144-6367

Mailing address

10091 Icicle Ridge CT
Las Vegas, NV 89141-8901
Phone (575) 312-4382

Other practice location 1

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 961-5000

Other names 1

  • Mahdika Keyonna Johnson Underwood Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240606000164 NV Practitioner - Pediatric Medicine 3274862289 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

657 N Town Ctr Dr
Las Vegas, NV 89144-6367
Phone (954) 939-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC CurrentSince Jun 25, 2025 Accepting new patients
Unlv Medicine CurrentSince Apr 23, 2024 Accepting new patients
Shadow Emergency Physicians PLLC Current Accepting new patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Apr 23, 2024 Accepting new patients
Shadow Emergency Physicians PLLC CurrentSince Jun 25, 2025 Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Locations

1524 Pinto Ln
Fl 2
Las Vegas, NV 89106
Phone (702) 671-2236

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

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

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

Organizations & group practices 7

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": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1770042079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10091 ICICLE RIDGE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891418901",
            "telephone_number": "575-312-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 N TOWN CENTER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446367",
            "telephone_number": "702-233-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3186 S Maryland Pkwy",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891092317",
            "country_code": "US",
            "telephone_number": "702-961-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MAHDIKA",
        "middle_name": "KEYONNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-16",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "DO3245",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NV",
            "license": "DO3245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAHDIKA",
            "last_name": "JOHNSON UNDERWOOD",
            "middle_name": "KEYONNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.