NPIMap

Organization Active NPI

Heart Light Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1790405348
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HEART LIGHT PSYCHIATRY LLC
Practice address
2450 Saint Rose Pkwy Ste 120
Henderson, NV 89074-7770
Phone
(480) 847-2998
Fax
(720) 367-5067
NPI assigned
Sep 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
Mr. Michael K Chism II, PMHNPNPI 1154780757
Title
Owner
Phone
(303) 587-8592

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2450 Saint Rose Pkwy Ste 120
Henderson, NV 89074-7770

Mailing address

3753 Howard Hughes Pkwy Ste 200
Las Vegas, NV 89169-0952
Phone (480) 847-2998

Other names 1

  • Mile High Psychiatry LLC Doing business as

National Provider Directory

National Provider Directory

Locations

2450 Saint Rose Pkwy
Ste 120
Henderson, NV 89074
Phone (480) 847-2998

Practitioners & affiliated clinicians

Practitioners 1

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": "1661990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1790405348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3753 HOWARD HUGHES PKWY STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891690952",
            "telephone_number": "480-847-2998",
            "fax_number": "720-367-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 SAINT ROSE PKWY STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747770",
            "telephone_number": "480-847-2998",
            "fax_number": "720-367-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART LIGHT PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "CHISM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-587-8592",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mile High Psychiatry LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mile High Psychiatry LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.