MR. JORDAN CARLEY (NPI# 1215363213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215363213 |
| Entity Type | Individual |
| Full Name | MR. JORDAN CARLEY |
| Credential | APRN, PMHNP-BC |
| Practice Address |
5412 Boulder Hwy Las Vegas NV 89122-6039 |
| Practice Telephone | 7022917121 |
| Practice Fax Number | 7029476335 |
| Mailing Telephone | 7022917121 |
| Mailing Fax Number | 7029476335 |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2019-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN75985 | NV | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
8230887 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4000 E Charleston Blvd, Ste 130, Las Vegas, NV 891046659 | 7029684000 | 7029684040 |
| 2775 S Jones Blvd Ste 101, Las Vegas, NV 891465632 | 7026853300 | 7025863333 |
| Street Address |
5412 BOULDER HWY |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89122-6039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346432374 | Pamela Hollis | Social Worker | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2007-08-14 |
| 1780283374 | Kelly Ann Waddilove | Case Manager/Care Coordinator | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-10-23 |
| 1942809157 | Christopher David Burns | Case Manager/Care Coordinator | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-10-19 |
| 1518564533 | Aimee Hollaway De Jesus | Counselor | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-10-02 |
| 1427662436 | Derick Ian Becios Manabat | Case Manager/Care Coordinator | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-09-07 |
| 1750994893 | Jeremie Bradford | Assistant Behavior Analyst | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-08-28 |
| 1093327116 | Hannah Nicole Schweinfurth | Assistant Behavior Analyst | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-08-19 |
| 1841818911 | Lucy Katende | Assistant Behavior Analyst | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-07-06 |
| 1114544863 | Jose Enrique Sandoval | Behavior Technician | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-06-29 |
| 1770106270 | Joseph N/a Ramirez | Behavior Technician | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902425523 | Dezirae Wilson | Technician | 5180 E Tropicana Ave Apt 46e, Las Vegas, NV 89122 | 2020-04-14 |
| 1407312366 | More Than Words LLC | Speech-Language Pathologist | 3430 Blue Ash Lane, Las Vegas, NV 89122 | 2019-02-15 |
| 1588130751 | Leslie Totress | Case Manager/Care Coordinator | 6368 Foxlyn Ave, Las Vegas, NV 89122 | 2018-10-15 |
| 1780100511 | Easy Living Behavioral Health LLC | Community Based Residential Treatment Facility, Mental Illness | 5069 Sun Valley Dr, Las Vegas, NV 89122 | 2017-08-14 |
| 1508381435 | Louie Taquiqui | Community/Behavioral Health | 3566 Tundra Swan St, Las Vegas, NE 89122 | 2017-08-11 |
| 1972032233 | Marilan Sanchez | Rehabilitation Practitioner | 5210 Emelita St, Las Vegas, NV 89122 | 2017-06-08 |
| 1023479599 | Tia Collins | Social Worker | 5412 Boulder Highway, Las Vegas, NV 89122 | 2016-03-11 |
| 1548673056 | Saba Chatoor | Counselor | 5446 Boulder Hwy Ste G3, Las Vegas, NV 89122 | 2014-06-03 |
| 1811328685 | Derrell Williams | Counselor | 3326 Wasatch Cedars St., Las Vegas, NV 89122 | 2013-12-04 |
| 1225466709 | The Lighthouse LLC | Community/Behavioral Health | 5710 E Tropicana Ave #2212, Las Vegas, NEVADA 89122 | 2013-10-22 |
| Find all providers in zip 89122 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404074 | Ibukun Odutola | Nurse Practitioner | 2605 E Flamingo Rd, Las Vegas, NV 89121-5241 | 2020-07-14 |
| 1225652191 | Angela Beth Wilson | Nurse Practitioner | 5440 W Sahara Ave Ste 220, Las Vegas, NV 89146-0355 | 2020-06-05 |
| 1104445394 | Universal Psychiatry LLC | Nurse Practitioner | 270 E Flamingo Rd Unit 122, Las Vegas, NV 89169-0325 | 2020-04-09 |
| 1952931271 | Paramount Healthcare Services Corp | Nurse Practitioner | 10141 Rockridge Peak Ave, Las Vegas, NV 89166-5200 | 2020-01-26 |
| 1730642182 | Aban Medical Services | Nurse Practitioner | 10145 Eagle Haven St, Las Vegas, NV 89141-8781 | 2019-04-11 |
| 1750857728 | Jan Michael Arceo | Nurse Practitioner | 3140 S Rainbow Blvd Ste 401, Las Vegas, NV 89146-6234 | 2018-10-17 |
| 1780110247 | Jon A Failla Aprn Pllc | Nurse Practitioner | 182 Apache Tear Ct, Las Vegas, NV 89123-2996 | 2017-05-03 |
| 1023565074 | Bright Star Nurse Care LLC | Nurse Practitioner | 8337 Fox Brook St, Las Vegas, NV 89139-6755 | 2016-09-07 |
| 1467805119 | Kasey James Dean | Nurse Practitioner | 3321 N Buffalo Dr, Suite 200, Las Vegas, NV 89129-6678 | 2016-07-18 |
| 1558757021 | Martin Binyange | Nurse Practitioner | 320 E Warm Springs Rd Unit 1, Las Vegas, NV 89119-4243 | 2015-04-12 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.