Individual provider Active NPI

Kori Leftwich, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1801403126
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
819339 Issued in NV
Practice address
6040 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5613
Phone
(702) 476-4900
Fax
(702) 476-4900
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 819339 NV Primary

Addresses

Primary practice location

6040 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5613

Mailing address

6040 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5613
Phone (702) 476-4900

Other practice location 1

526 S Tonopah Dr Ste 160
Las Vegas, NV 89106-4044
Phone (702) 897-7250

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
I20210112000250 NV Practitioner - Nurse Practitioner 9739592783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eid Nevada Critical Care PLLCGroup PAC ID 9537357793, 62 clinicians
John Reitano MD PLLCGroup PAC ID 2365862406, 6 clinicians

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 731-8000

526 S Tonopah Dr
Suite 160
Las Vegas, NV 89106-4044
Phone (702) 897-7250

Hospital & facility affiliations

  • Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
819339NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John Reitano M.D. PLLC CurrentSince Dec 18, 2024 Accepting new patients
Eid Nevada Critical Care PLLC CurrentSince Jan 1, 2021 Accepting new patients
John Reitano M.D. PLLC Past Accepting new patients

Locations

1801 W Olympic Blvd
#1270
Pasadena, CA 91199

526 S Tonopah Dr
Ste 140
Las Vegas, NV 89106
Phone (702) 440-8440

6040 S Fort Apache Rd
Ste 100
Las Vegas, NV 89148
Phone (702) 475-4007

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

526 S Tonopah Dr
Ste 160
Las Vegas, NV 89106
Phone (702) 538-7783

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1801403126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 S FORT APACHE RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485613",
            "telephone_number": "702-476-4900",
            "fax_number": "702-476-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 S FORT APACHE RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485613",
            "telephone_number": "702-476-4900",
            "fax_number": "702-476-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "526 S Tonopah Dr Ste 160",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064044",
            "country_code": "US",
            "telephone_number": "702-897-7250",
            "fax_number": "702-706-4838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEFTWICH",
        "first_name": "KORI",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "819339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.