NPIMap

Organization Active NPI

Progressive Psychiatric Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
National Provider Identifier
1811639685
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PROGRESSIVE PSYCHIATRIC SERVICES, LLC
Practice address
2830 S Jones Blvd Ste 3
Las Vegas, NV 89146-5652
Phone
(702) 899-1208
Fax
(702) 778-7632
NPI assigned
Apr 11, 2022
Last updated
Dec 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Akinyemi Akinwumiju, MD
Title
Owner
Phone
(702) 899-1208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

2830 S Jones Blvd Ste 3
Las Vegas, NV 89146-5652

Mailing address

2830 S Jones Blvd Ste 3
Las Vegas, NV 89146-5652
Phone (702) 899-1208

Other practice location 1

2830 S Jones Blvd Ste 3
Las Vegas, NV 89146-5652
Phone (702) 899-1208

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220809001750 NV Part B Supplier - Clinic/Group Practice 4789066622 Receives reassigned benefits from 9 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2830 S Jones Blvd
Ste 3
Las Vegas, NV 89146
Phone (702) 899-1208

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1811639685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 S JONES BLVD STE 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465652",
            "telephone_number": "702-899-1208",
            "fax_number": "702-778-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 S JONES BLVD STE 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465652",
            "telephone_number": "702-899-1208",
            "fax_number": "702-778-7632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2830 S Jones Blvd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891465652",
            "country_code": "US",
            "telephone_number": "702-899-1208",
            "fax_number": "702-778-7632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROGRESSIVE PSYCHIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-11",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "AKINWUMIJU",
        "authorized_official_first_name": "AKINYEMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-899-1208",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.