NPIMap

Organization Active NPI

Blue 42 Inc

  • Community Health Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1902500028
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
BLUE 42 INC
Practice address
1230 W Owens Ave Ste 1
Las Vegas, NV 89106-2451
Phone
(775) 538-5104
NPI assigned
Mar 30, 2023
Last updated
Jun 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Authorized official

Name
Jshauntae MarshallNPI 1417728130
Title
Director
Phone
(775) 538-5104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Case Management Agency 251B00000X
Birthing Clinic/Center 261QB0400X
Community Health Clinic/Center 261QC1500X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Lactation Consultant (Non-RN) 174N00000X
Doula 374J00000X

Addresses

Primary practice location

1230 W Owens Ave Ste 1
Las Vegas, NV 89106-2451

Mailing address

8046 Pavarotti Ave
Las Vegas, NV 89178-8264
Phone (775) 538-5104

Other practice location 1

1001 Bannock St
Denver, CO 80204-4150
Phone (719) 738-8078

National Provider Directory

National Provider Directory

Locations

1230 W Owens Ave
Ste 1
Las Vegas, NV 89106
Phone (203) 578-6478

Practitioners & affiliated clinicians

Practitioners 1

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": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719100800000",
    "number": "1902500028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8046 PAVAROTTI AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891788264",
            "telephone_number": "775-538-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 W OWENS AVE STE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062451",
            "telephone_number": "775-538-5104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Bannock St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044150",
            "country_code": "US",
            "telephone_number": "719-738-8078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE 42 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "JSHAUNTAE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "775-538-5104"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 23, 2024; 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.