Festus Ebonka

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN000902 Issued in NV

Practice address

1721 E Charleston Blvd
Las Vegas, NV 89104-1902

Phone

(702) 515-9680

Fax

(702) 685-9674

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

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.

• Nevada Integrated Behavioral Services Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Las Vegas, NV
  • NPI 1104308147
  NPD (past) Authorized official
• Nevada Integrated Behavioral Services Inc.

  • Psychiatric Hospital
  • Las Vegas, NV
  • NPI 1952852097
  NPD (past) Authorized official
• Nevada Integrated Behavioral Services Inc.

  • Methadone Clinic
  • Las Vegas, NV
  • NPI 1932575156
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1932241007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 E. CHARLESTON BLVD.",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041902",
            "telephone_number": "702-515-9680",
            "fax_number": "702-685-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041902",
            "telephone_number": "702-515-9680",
            "fax_number": "702-685-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBONKA",
        "first_name": "FESTUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN000902",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "APRN000902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan-Terrence Pascual Ebiya
• Ebl Inc.
• Ebla Hospitalists Group, LLC
• Chrislyn Lee Eblacas, CPC INTERN
• Emmanuel Ebo
• Ebonny Behavioral Care Services Corporation
• Ebonny Home Health Agency Inc
• Ebonny Ventures Inc
• Ebonny Ventures LLC
• Ebony Relief Charitable Inc.

• Psychiatric/Mental Health Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• 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.