Individual provider Active NPI

Brett Wade Persinger, FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1912737123
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
816322 Issued in NV
Practice address
4029 Dean Martin Dr
Las Vegas, NV 89103-4138
Phone
(620) 757-3968
NPI assigned
Aug 2, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 816322 NV Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 816322 NV

Addresses

Primary practice location

4029 Dean Martin Dr
Las Vegas, NV 89103-4138

Mailing address

8123 Fairfield Crescent CT
Las Vegas, NV 89113-1889
Phone (620) 757-3968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108003204 NV Practitioner - Nurse Practitioner 6800329434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anywhere Clinic LLCGroup PAC ID 4183996317, 32 clinicians

Practice addresses (Care Compare)

4029 Dean Martin Dr
Las Vegas, NV 89103-4138
Phone (702) 848-2256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
816322NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anywhere Clinic LLC Psychiatric/Mental Health CurrentSince Oct 1, 2024 Accepting new patients

Locations

4029 Dean Martin Dr
Las Vegas, NV 89103
Phone (702) 919-1508

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1912737123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8123 FAIRFIELD CRESCENT CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131889",
            "telephone_number": "620-757-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 DEAN MARTIN DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034138",
            "telephone_number": "620-757-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSINGER",
        "first_name": "BRETT",
        "middle_name": "WADE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "816322",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "816322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.