Individual provider Active NPI

Jordan Kelley, CRNA

  • Certified Registered Nurse Anesthetist
  • Las Vegas, NV
National Provider Identifier
1891319398
Registry record updated May 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
826262 Issued in NV
Practice address
7160 Rafael Rivera Way Ste 210
Las Vegas, NV 89113-5395
Phone
(702) 878-0070
NPI assigned
Jun 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 826262 NV Primary

Addresses

Primary practice location

7160 Rafael Rivera Way Ste 210
Las Vegas, NV 89113-5395

Mailing address

7160 Rafael Rivera Way Ste 210
Las Vegas, NV 89113-5395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221021001530 NV Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951777580 Reassigns benefits to 1 organization
I20230602002202 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951777580

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of New England, College of Osteo Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fielden,Hanson,Isaacs,Miyada,Robison,Yeh LTDGroup PAC ID 5799683462, 168 clinicians

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 961-8434

Hospital & facility affiliations

  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039
  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045

Merit-based Incentive Payment System (MIPS)

Final score
78.25 of 100Reported as group
Quality
74.41
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95002076CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fielden Hanson Isaacs Miyada Robison Yeh LTD Nurse Anesthetist, Certified Registered CurrentSince Oct 7, 2022 Accepting new patients
G & G Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 14, 2023 Accepting new patients
Arizona Anesthesia Consultants, Inc. Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2022 Accepting new patients

Locations

820 E Mountain View St
Barstow, CA 92311
Phone (760) 256-1761

9127 W Russell Rd
Ste 110
Las Vegas, NV 89148
Phone (702) 209-2042

7160 Rafael Rivera Way
Ste 210
Las Vegas, NV 89113

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

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

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 2

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": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746835200000",
    "number": "1891319398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7160 RAFAEL RIVERA WAY STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891135395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7160 RAFAEL RIVERA WAY STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891135395",
            "telephone_number": "702-878-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JORDAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2025-05-10",
        "certification_date": "2025-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NV",
            "license": "826262",
            "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 May 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.