JACKI MARIE DEGUZMAN (NPI# 1013206614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013206614 |
| Entity Type | Individual |
| Full Name | JACKI MARIE DEGUZMAN |
| Credential | M.D. |
| Practice Address |
10105 Banburry Cross Dr Suite 150 Las Vegas NV 89144-6646 |
| Mailing Address |
Po Box 15645 Suite 301 Las Vegas NV 89114-5645 |
| Practice Telephone | 7028775199 |
| Practice Fax Number | 7028543259 |
| Mailing Telephone | 7028775199 |
| Mailing Fax Number | 7028543259 |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2017-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 15384 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | P01612764 | 01 | |
| NV | SMA CONVENIENT CARE MEDICARE | V108806 | 01 |
| Street Address |
10105 BANBURRY CROSS DR SUITE 150 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89144-6646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477532372 | Michael O Nyarko | Pediatrics | 10105 Banburry Cross Dr, Suite 370, Las Vegas, NV 89144-6646 | 2006-01-10 |
| 1205472719 | Caroline Eva Talbot | Pediatrics | 10105 Banburry Cross Dr, Las Vegas, NV 89144-6646 | 2019-11-19 |
| 1487121067 | Teresa M Baker | Physician Assistant | 10105 Banburry Cross Dr, Las Vegas, NV 89144-6646 | 2018-10-31 |
| 1598294308 | Chely Arias | Specialist/Technologist | 10105 Banburry Cross Dr, Las Vegas, NV 89144-6646 | 2017-06-06 |
| 1275985475 | J Michele Lentz Apn Msn LLC | Nurse Practitioner | 10105 Banburry Cross Dr, Suite 130, Las Vegas, NV 89144-6646 | 2016-07-12 |
| 1265896880 | David Richards | Internal Medicine | 10105 Banburry Cross Dr, Las Vegas, NV 89144-6646 | 2016-04-09 |
| 1932477296 | Womens Specialty Care, Lllp | Non-Pharmacy Dispensing Site | 10105 Banburry Cross Dr, Suite 460, Las Vegas, NV 89144-6646 | 2011-12-01 |
| 1134437445 | Orthopaedic Solutions LLC | Orthopaedic Surgery | 10105 Banburry Cross Dr, Suite 445, Las Vegas, NV 89144-6506 | 2010-09-21 |
| 1790011922 | Monica Hall | Physician Assistant | 10105 Banburry Cross Dr, #150, Las Vegas, NV 89144-6646 | 2009-10-22 |
| 1003053828 | William Ralston Mcgee II | Orthopaedic Surgery | 10105 Banburry Cross Dr, # 445, Las Vegas, NV 89144-6646 | 2009-01-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033609599 | Anila Naz | Technician | 1529 Waterton Drive, Las Vegas, NV 89144 | 2018-05-10 |
| 1467987487 | Judith L. Tan | Nurse Practitioner | Summerlin Hospital, 657 N Town Center Dr, Las Vegas, NV 89144 | 2017-04-27 |
| 1871049437 | Derek Anthony Smith | Physical Therapist | 89135, 10550 W Park Run Dr, Las Vegas, NV 89144 | 2016-09-01 |
| 1619324662 | Sydney Spoon | Dietitian, Registered | 624 Canyon Greens Dr, Las Vegas, NV 89144 | 2016-05-19 |
| 1629455985 | Md24 Nv, Inc. | Nurse Practitioner | 1180 North Town Center Dr, Ste 100, Las Vegas, NV 89144 | 2015-05-06 |
| 1053652628 | Melvin Lackey Jr. | Behavioral Analyst | 10708 Esk Dr, Las Vegas, NV 89144 | 2013-03-07 |
| 1740445667 | Jaydee R. Lumbad | Family Medicine | 1111 N Town Center Drive, Las Vegas, NV 89144 | 2008-07-21 |
| 1700053824 | Samim Enayat | Internal Medicine | 10105 Banburry Cross Dr Ste 130, Las Vegas, NV 89144 | 2008-05-08 |
| 1629252457 | Edmund Reyes Goroza | Pediatrics | 10105 Banburry Cross Dr Ste 170, Las Vegas, NV 89144 | 2007-12-28 |
| 1730375262 | H.l.greenberg M.d., Ltd. | Clinic/Center | 653 N. Town Center Drive, Ste #410, Las Vegas, NV 89144 | 2007-09-18 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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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.