Individual provider Active NPI

Kelijah Blackwell

  • Personal Care Attendant
  • Las Vegas, NV
National Provider Identifier
1841108396
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
6546 Jordan River Dr
Las Vegas, NV 89156-3750
Phone
(725) 275-0552
NPI assigned
Aug 27, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X NV Primary

Addresses

Primary practice location

6546 Jordan River Dr
Las Vegas, NV 89156-3750

Mailing address

6546 Jordan River Dr
Las Vegas, NV 89156-3750

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1841108396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6546 JORDAN RIVER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891563750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6546 JORDAN RIVER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891563750",
            "telephone_number": "725-275-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "KELIJAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NV",
            "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 Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.