JEFFERY RAY TACKETT APRN, PPCNP-C
NPI 1376956789
Nurse Practitioner - Pediatrics in Las Vegas, NV

Q: What is Jeffery Tackett's NPI number?

The NPI number for Jeffery Tackett is 1376956789. It was assigned to this individual provider in the NPPES registry on June 4, 2014.

Q: What is Jeffery Tackett's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Jeffery Tackett was last updated on November 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 04, 2014PECOS Enrolled

2650 N TENAYA WAY STE 308, LAS VEGAS, NV 89128(702) 870-2099(702) 869-5347 Get Directions Write a Review

NPPES record last updated: November 3, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 3, 2022, Feb 18, 2021, Feb 27, 2020 and 1 more (4 updates tracked since 2016).

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About Jeffery Ray Tackett Aprn, Ppcnp-c NPPES

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

JEFFERY RAY TACKETT APRN, PPCNP-C (NPI 1376956789) is an individual pediatrics provider in Las Vegas, Nevada, licensed in Nevada (APRN002155) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376956789

Entity TypeIndividualMale

Primary Taxonomy363LP0200X

Provider Legal NameJEFFERY RAY TACKETTCredential: APRN, PPCNP-C

Location Address2650 N TENAYA WAY STE 308Las Vegas, NV 89128-1102

Mailing Address6355 S Buffalo Dr Fl 3Las Vegas, NV 89113-2133 · (702) 216-3346

Phone(702) 870-2099

Fax(702) 869-5347

Sole ProprietorNo

Enumeration DateJune 4, 2014

Last NPPES UpdateNovember 3, 20224 updates tracked since enumeration

NPPES CertifiedNovember 3, 2022

✔ NPI 1376956789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

Licenses✔ Licensed in NV · APRN002155✔ Licensed in TN · 18745

2650 N TENAYA WAY STE 308, Las Vegas, NV 89128

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeffery Ray Tackett Aprn, Ppcnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jeffery Tackett reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Intermountain Medical Holdings Nevada Inc

18 mi

Internal Medicine

595 W LAKE MEAD PKWY
Henderson, NV 89015

Reassigned Medicare billing, Nevada enrollment
521 clinicians in this Medicare group

NPI 1245997279 (702) 566-5500

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.51 typical visit price

range $57.07 – $173.24

Typical copayment $22.12 (range $14.26 – $43.31)

Most-billed visit code 99203

Established Patient

$100.60 typical visit price

range $18.27 – $140.96

Typical copayment $25.15 (range $4.56 – $35.24)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ERIK GRIMM DO

Pediatrics

2650 N TENAYA WAY STE 308
LAS VEGAS, NV 89128

Clark County (702) 870-2099

NAM THAI NGUYEN MD

Pediatrics

2650 N TENAYA WAY STE 308
LAS VEGAS, NV 89128

Clark County (702) 870-2099

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 Jeffery Tackett's NPI number?

The NPI number for Jeffery Tackett is 1376956789. It was assigned to this individual provider in the NPPES registry on June 4, 2014.

Where is Jeffery Tackett located?

Jeffery Tackett practices at 2650 N Tenaya Way Ste 308, Las Vegas, NV 89128. The listed phone number is (702) 870-2099.

What is Jeffery Tackett's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Jeffery Tackett enrolled in Medicare?

Yes. Jeffery Tackett is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jeffery Tackett's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffery Tackett reassigns Medicare benefits to Intermountain Medical Holdings Nevada Inc (Henderson, NV). The 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 Jeffery Tackett's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jeffery Tackett accept?

Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Jeffery Tackett 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 Jeffery Tackett was last updated on November 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.