NPIMap

Organization Active NPI

Oluyemisi Olayinka Adedotun

  • Adult Mental Health Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1780059352
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
2002233062101 Issued in NV
Legal business name
OLUYEMISI OLAYINKA ADEDOTUN
Practice address
3430 E Flamingo Rd Ste 100
Las Vegas, NV 89121-5018
Phone
(702) 444-4690
Fax
(702) 444-0977
NPI assigned
Dec 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Oluyemisi Olayinka Adedotun, APRNNPI 1629393632
Title
Owner
Phone
(702) 444-4690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 2002233062101 NV Primary

Addresses

Primary practice location

3430 E Flamingo Rd Ste 100
Las Vegas, NV 89121-5018

Mailing address

3430 E Flamingo Rd Ste 100
Las Vegas, NV 89121-5018
Phone (702) 444-4690

Other names 2

  • Psychiatric Solutions Clinic Doing business as
  • Psychiatric Solutions Clinic LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210519000700 NV Part B Supplier - Clinic/Group Practice 9931508280 Receives reassigned benefits from 3 practitioners
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2324536Psychiatric Solutions Clinic LLC3430 E Flamingo Road Ste 100, Las Vegas, NV 89121Certificate of waiverMay 26, 2027

National Provider Directory

National Provider Directory

Locations

3430 E Flamingo Rd
Ste 100
Las Vegas, NV 89121
Phone (702) 444-4690

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1780059352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 E FLAMINGO RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215018",
            "telephone_number": "702-444-4690",
            "fax_number": "702-444-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 E FLAMINGO RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215018",
            "telephone_number": "702-444-4690",
            "fax_number": "702-444-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLUYEMISI OLAYINKA ADEDOTUN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-08",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "ADEDOTUN",
        "authorized_official_first_name": "OLUYEMISI",
        "authorized_official_middle_name": "OLAYINKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-444-4690",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NV",
            "license": "2002233062101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Solutions Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Psychiatric Solutions Clinic LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 18, 2022; 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.