Individual provider Active NPI

Phyllis A Tellis

  • Community Health Worker
  • Las Vegas, NV
National Provider Identifier
1932347242
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
CHW2-5120 Issued in NV
Practice address
3030 N Torrey Pines Dr
Las Vegas, NV 89108-4326
Phone
(469) 584-0824
NPI assigned
Jan 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X PRSS-INT-5262 NV
Phlebotomy Technician 246RP1900X NV
Other TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 247200000X
Case Management Agency 251B00000X
Doula 374J00000X 0036 NV
DoulaGroup: 193200000X MULTI-SPECIALTY GROUP 374J00000X
Community Health Worker 172V00000X CHW2-5120 NV Primary

Addresses

Primary practice location

3030 N Torrey Pines Dr
Las Vegas, NV 89108-4326

Mailing address

800 N Rainbow Blvd Ste 218
Las Vegas, NV 89107-1189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CHW2-5120NVMDCommunity Health Worker
PRSS-INT-5262NVMDPeer Specialist
0036NVMDDoula

Practice roles

OrganizationSpecialtyStatusNew patients
All Care Wellness Center Community Health Worker Current Accepting new patients
Tellus Wellness Connection Behavior Technician Current Accepting new patients
Tellus Wellness Connection Multi-Specialty Current Accepting new patients

Locations

800 N Rainbow Blvd
Ste 218
Las Vegas, NV 89107
Phone (702) 205-0322

2350 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 214-2165

732 S 6th St
Ste 4459
Las Vegas, NV 89101
Phone (469) 584-0824

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1932347242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD STE 218",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 N TORREY PINES DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891084326",
            "telephone_number": "469-584-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLIS",
        "first_name": "PHYLLIS",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "NV",
            "license": "PRSS-INT-5262",
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "NV",
            "license": null,
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NV",
            "license": "0036",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NV",
            "license": "CHW2-5120",
            "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 Aug 7, 2025; 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.