Individual provider Active NPI

Jaymi Anne Mackenzie

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1982362414
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
846933 Issued in NV
Practice address
2700 Fire Water CT
Las Vegas, NV 89117-0400
Phone
(630) 347-2005
NPI assigned
Dec 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 846933 NV Primary

Addresses

Primary practice location

2700 Fire Water CT
Las Vegas, NV 89117-0400

Mailing address

2700 Fire Water CT
Las Vegas, NV 89117-0400
Phone (630) 347-2005

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
I20220322000728 NV Practitioner - Nurse Practitioner 6608261078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 731-8585

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Emergency Services Scherr LTD Nurse Practitioner CurrentSince Mar 1, 2022 Accepting new patients
Edwards MD PC CurrentSince Dec 3, 2024 Accepting new patients
Fremont Emergency Services Scherr LTD Nurse Practitioner CurrentSince Mar 1, 2022 Accepting new patients
Fremont Emergency Services Scherr LTD Current Accepting new patients

Locations

1155 Raiders Way
Henderson, NV 89052
Phone (702) 369-7671

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

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

3186 S Maryland Pkwy
Ste 410
Las Vegas, NV 89109

Organizations & group practices 4

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": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1982362414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 FIRE WATER CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891170400",
            "telephone_number": "630-347-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 FIRE WATER CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891170400",
            "telephone_number": "630-347-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "JAYMI",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "846933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.