Illyas Malik Jenkins

Primary specialty

Rehabilitation CounselorTaxonomy code 225C00000X

Practice address

3450 W Cheyenne Ave Ste 300
N Las Vegas, NV 89032-8223

Phone

(954) 380-0875

NPI assigned

Feb 10, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Epic Transformation Wellness Center, LLC

  • Mental Health Counselor
  • Las Vegas, NV
  • NPI 1710779905
  NPD Authorized official

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1841596731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5423 SUNNYVILLE ST",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890317986",
            "telephone_number": "954-380-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 W CHEYENNE AVE STE 300",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890328223",
            "telephone_number": "954-380-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "ILLYAS",
        "middle_name": "MALIK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-10",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Biljana Janic, M.D.
• Elizabeth Jarman, LCSW
• Jeaniene a Talley MD a Professional
• Jacqueline Danielle Jefferson
• Aaron Christopher Jenkins
• Nadia Jenkins
• Traford Montez Jenkins
• Jennifer Tran, M.D., PLLC
• Jfgo Health Pharmacies LLC
• Jawad A Jilani, D.O.

• Rehabilitation Counselor in N Las Vegas, NV
• Providers in N Las Vegas, NV by specialty
• Rehabilitation Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.