Organization Active NPI

Neuro Thrive PC

  • Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1013605880
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
NEURO THRIVE PC
Practice address
10472 Wellington Manor Ave
Las Vegas, NV 89129-4514
Phone
(301) 385-1784
NPI assigned
Apr 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Evan FakhreddineNPI 1265933584
Title
Director
Phone
(301) 385-1784

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

10472 Wellington Manor Ave
Las Vegas, NV 89129-4514

Mailing address

10472 Wellington Manor Ave
Las Vegas, NV 89129-4514
Phone (301) 385-1784

National Provider Directory

National Provider Directory
Tax ID family
Neuro Thrive PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8910 W Tropicana Ave
Ste 1
Las Vegas, NV 89147
Phone (702) 292-2596

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1013605880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10472 WELLINGTON MANOR AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891294514",
            "telephone_number": "301-385-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10472 WELLINGTON MANOR AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891294514",
            "telephone_number": "301-385-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO THRIVE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-28",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "FAKHREDDINE",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-385-1784"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.