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CHANGING MINDS MEDICINE LLC
NPI 1205455961
Nurse Practitioner - Family in Henderson, NV

Active since April 13, 2020
2960 W HORIZON RIDGE PKWY, HENDERSON, NV 89052(702) 405-8088(702) 405-6066 Get Directions Write a Review

NPPES record last updated: January 30, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Changing Minds Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANGING MINDS MEDICINE LLC (NPI 1205455961) is a healthcare organization registered as a family in Henderson, Nevada and active in the NPI registry since April 2020. The organization lists Jamie Brown, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1205455961
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameCHANGING MINDS MEDICINE LLC
Location Address2960 W HORIZON RIDGE PKWYHenderson, NV 89052-4666
Mailing AddressPo Box 752003Las Vegas, NV 89136-2003 · (702) 405-8088 · Fax (702) 405-6066
Phone(702) 405-8088
Fax(702) 405-6066
Organization SubpartNo
Authorized OfficialJamie BrownBusiness Manager · (702) 405-8088
Enumeration DateApril 13, 2020
Last NPPES UpdateJanuary 30, 2024
NPPES CertifiedJanuary 30, 2024
✔ NPI 1205455961 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
2960 W HORIZON RIDGE PKWY, Henderson, NV 89052
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Changing Minds Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Changing Minds Medicine LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nicole Vaughn, APRN
Nurse Practitioner
NPI 1023469202
911 N BUFFALO DR UNIT 213
Las Vegas, NV 89128
(702) 405-8088
✔ PECOS✔ Accepts Medicare15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Changing Minds Medicine LLC's NPI number?

The NPI number for Changing Minds Medicine LLC is 1205455961. It was assigned to this organization in the NPPES registry on April 13, 2020.

Where is Changing Minds Medicine LLC located?

Changing Minds Medicine LLC is located at 2960 W Horizon Ridge Pkwy, Henderson, NV 89052. The listed phone number is (702) 405-8088.

What is Changing Minds Medicine LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Changing Minds Medicine LLC enrolled in Medicare?

Yes. Changing Minds Medicine LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Changing Minds Medicine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Changing Minds Medicine LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Changing Minds Medicine LLC accept?

Health plans from Molina Healthcare list Changing Minds Medicine LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Changing Minds Medicine LLC was last updated on January 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.