ELY SHOSHONE TRIBE SOS Verified
400 NEWE VIEW, ELY, NV 89301
NPI Number
1548217409
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: She Tribe Inc.
Entity Number: E51916202025-0
Entity Type: Domestic Corporation
Entity Status: Active
Formation Date: 2025-09-24
Status Changed: 2025-09-24
Name Match: 80%
Registered Agent
Name: UNITED STATES CORPORATION AGENTS, INC.
Type: Commercial Registered Agent
Address: 6605 Grand Montecito Pkwy, Suite 100, Las Vegas, NV, 89149
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| President | Davon Jackson | 1831 Alif Rd NE, Rio Rancho, NM | Active |
| Secretary | Brenda Carabajal | 1831 Alif Rd NE, Rio Rancho, NM | Active |
| Treasurer | Davon Jackson | 1831 Alif Rd NE, Rio Rancho, NM | Active |
| Director | Brenda Carabajal | 1831 Alif Rd NE, Rio Rancho, NM | Active |
Total Medicaid Payments
$1,182,764
-51% vs specialty average
Patients Seen
1,619
Total Claims
2,847
$ Per Patient
$731
Specialty avg: $313
Specialty Rank
#19 of 62
Clinic/Center providers in Nevada
Peer Average
$2,426,494
Average total for Clinic/Center
Claims per Patient
1.8
Average visits / services per person
Payments by Year
How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.
| Year | Total Paid | % of Max |
|---|---|---|
| 2018 | $233,619 | |
| 2019 | $114,660 | |
| 2020 | $97,587 | |
| 2021 | $280,311 | |
| 2022 | $274,916 | |
| 2024 | $181,671 |
Procedure Code Breakdown
The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.
| HCPCS Code | Description | Claims | Paid | % of Total | Avg per Claim |
|---|---|---|---|---|---|
| T1015 | All-inclusive clinic visit — covers everything in one trip to the clinic | 2,847 | $1,182,764 | 100.0% | $415 |
About This Data
This data comes from the HHS Medicaid Provider Spending dataset (opendata.hhs.gov). It shows payments made through Nevada Medicaid from 2018–2024. High payments do not mean a provider is doing anything wrong — some specialties naturally cost more, and busy providers see more patients. But unusually high numbers compared to peers can be worth a closer look.