Individual provider Active NPI

Amanda Ashley Carnevale

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1790546596
Registry record updated Feb 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
824146 Issued in NV
Practice address
6628 Sky Pointe Dr Ste 103
Las Vegas, NV 89131-4071
Phone
(702) 550-9199
NPI assigned
Jan 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 824146 NV
Registered Nurse 163W00000X 9637962 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 824146 NV Primary

Addresses

Primary practice location

6628 Sky Pointe Dr Ste 103
Las Vegas, NV 89131-4071

Mailing address

6628 Sky Pointe Dr Ste 103
Las Vegas, NV 89131-4071
Phone (702) 550-9199

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
I20241120003939 NV Practitioner - Nurse Practitioner 4385179894 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9637962FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Olive Branch Psychiatrics Psychiatric/Mental Health CurrentSince Nov 11, 2024 Accepting new patients

Locations

7045 W Ann Rd
Ste 140
Las Vegas, NV 89130
Phone (702) 550-9199

6628 Sky Pointe Dr
Ste 103
Las Vegas, NV 89131
Phone (702) 550-9199

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738454400000",
    "number": "1790546596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6628 SKY POINTE DR STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891314071",
            "telephone_number": "702-550-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6628 SKY POINTE DR STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891314071",
            "telephone_number": "702-550-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEVALE",
        "first_name": "AMANDA",
        "middle_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2025-02-02",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "824146",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9637962",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "824146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.