Jared Kerry Green

Individual provider Active NPI Home Health Registered Nurse · Mesquite, NV

NPI 1801729355 · NPPES record last updated Jun 4, 2026

Key facts

NPI
1801729355
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
821483 (NV)
Practice address
12 W Mesquite Blvd Ste 113
Mesquite, NV 89027-4774
Phone
(702) 346-4883
Fax
(702) 664-0426
NPI assigned
Jun 4, 2026
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
821483NVMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Summerlin Healthcare, Inc. Past Accepting new patients
Summerlin Healthcare, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered Nurse 163WH1000X 821483 NV
Home Health Registered Nurse 163WH0200X 821483 NV Yes

Addresses

Primary practice location

12 W Mesquite Blvd Ste 113
Mesquite, NV 89027-4774

Mailing address

12 W Mesquite Blvd Ste 113
Mesquite, NV 89027-4774
Phone (702) 346-4883

Other providers in Mesquite, NV

All providers in Mesquite, NV · Home Health Registered Nurse in Nevada

Sources for this page

Verify at the official NPI Registry.