CHANGING MINDS MEDICINE (NPI# 1205455961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205455961 |
| Entity Type | Organization |
| Organization Name | CHANGING MINDS MEDICINE |
| Practice Address |
911 N Buffalo Dr Unit 213 Las Vegas NV 89128-0381 |
| Mailing Address |
Po Box 752003 Las Vegas NV 89136-2003 |
| Practice Telephone | 7024673559 |
| Practice Fax Number | 7024056066 |
| Mailing Telephone | 7024058088 |
| Mailing Fax Number | 7024056066 |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2020-04-13 |
| Authorized Official Name | JAMIE LYNN BROWN (BUSINESS MANAGER) |
| Authorized Official Telephone | 7024058088 |
| Is Organization Subpart | Y |
| Parent Organization Name | NICOLE R VAUGHN CHANGING MINDS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
911 N BUFFALO DR UNIT 213 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89128-0381 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760411318 | Angela Alesi | Nurse Practitioner | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2006-07-03 |
| 1730728585 | Valan Kam | Nurse Practitioner | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2019-12-26 |
| 1992367080 | Kelly Bucalo | Nurse Practitioner | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2019-06-28 |
| 1760993117 | Nicole R Vaughn Changing Minds | Counselor | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2017-10-12 |
| 1033628532 | Morgan Futch Moumouris | Counselor | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2017-09-27 |
| 1558884031 | Erica R Arnold | Community/Behavioral Health | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2017-07-17 |
| 1871015446 | Mary Louise Albert | Community/Behavioral Health | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2017-07-14 |
| 1053852640 | Schuyler Ritchie | Behavioral Analyst | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2017-03-15 |
| 1023469202 | Nicole Renee Vaughn | Nurse Practitioner | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2016-06-28 |
| 1740642800 | Samantha Hiltz | Behavioral Analyst | 911 N Buffalo Dr Unit 213, Las Vegas, NV 89128-0381 | 2016-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374256 | Dmc Medical Clinic Ltd | Family Medicine | 7140 Smoke Ranch Road, 150, Las Vegas, NV 89128 | 2020-10-23 |
| 1619589462 | Eldercare Services Lv, LLC | Technician | 8430 W. Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-08-21 |
| 1508477308 | Amneris Lizet Duran-brocato | Technician | 1150 North Buffalo Dr. Apt 2120, Las Vegas, NV 89128 | 2020-08-14 |
| 1366082612 | Ar Home Health Management LLC | Home Health | 7465 W Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-01-14 |
| 1114563731 | Leslie A Pasternack | Acupuncturist | Integrated Acupuncture of Southern Nevada, 7250 Peak Dr #106, Las Vegas, NV 89128 | 2019-11-19 |
| 1154977940 | Devora Susana Leon-lopez | Chore Provider | 7320 Smoke Ranch Rd. Ste. H, Las Vegas, NV 89128 | 2019-08-16 |
| 1659924884 | Blanca Estela Garnica-mendez | Chore Provider | 7320 Smoke Ranch Rd. Suite H, Suite H, Las Vegas, NV 89128 | 2019-07-17 |
| 1467913160 | Sherwin Necunazar Azad | Student in an Organized Health Care Education/Training Program | Mountainview Hospital Gme, 3100 N. Tenaya Way, Las Vegas, NV 89128 | 2019-03-26 |
| 1962963801 | Michael Richard Korczynski | Student in an Organized Health Care Education/Training Program | 3100 North Tenaya Way, Las Vegas, NV 89128 | 2019-03-25 |
| 1013477041 | Yuanlong Zhao | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way Graduate Medical Education, Las Vegas, NV 89128 | 2019-03-25 |
| Find all providers in zip 89128 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396651 | Alma F Talavera | Nurse Practitioner | 5982 Juniper Falls Ave, Las Vegas, NV 89130-2827 | 2020-11-06 |
| 1154922300 | Reynaly Campos | Nurse Practitioner | 10680 Spruce Bough St, Las Vegas, NV 89183-4631 | 2020-11-04 |
| 1811596463 | Carolina Salaberrios | Nurse Practitioner | 8440 W Lake Mead Blvd Ste 111, Las Vegas, NV 89128-7648 | 2020-10-23 |
| 1851990840 | John Marius Agravio Tolentino | Nurse Practitioner | 3557 Winter Wren St, Las Vegas, NV 89122-3539 | 2020-10-21 |
| 1811596760 | Emmelyn Pineda Rivas | Nurse Practitioner | 7852 Lovely Pine Pl, Las Vegas, NV 89143-4431 | 2020-10-21 |
| 1659979052 | Francis Torres | Nurse Practitioner | 10010 Fort Pike St, Las Vegas, NV 89178-7543 | 2020-10-16 |
| 1144828849 | Julio Arvie Mata Madarazo Jr. | Nurse Practitioner | 6284 Canvasback Ave, Las Vegas, NV 89122-3545 | 2020-10-14 |
| 1104424076 | Khelsey Macaspac | Nurse Practitioner | 6446 Dunns River St, Las Vegas, NV 89166-8064 | 2020-10-13 |
| 1912505199 | Angelica Villahermosa | Nurse Practitioner | 8115 Dancing Bull Ct, Las Vegas, NV 89139-6702 | 2020-10-11 |
| 1467050625 | Ruby Borja | Nurse Practitioner | 7329 Perkins Hill St, Las Vegas, NV 89166-6505 | 2020-10-10 |
| 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.