Active NPI
Kareem Jabraun Gwinn
- Physical Therapy Assistant
- Las Vegas, NV
National Provider Identifier
1043728033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A-0929
- Practice address
- 3831 W Charleston Blvd
Las Vegas, NV 89102-1859 - Phone
- (702) 876-1733
- NPI assigned
- Jan 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A-0929 | NV | Primary |
Addresses
Primary practice location
3831 W Charleston Blvd
Las Vegas, NV 89102-1859
Mailing address
3831 W Charleston Blvd
Las Vegas, NV 89102-1859
Phone (702) 876-1733
Other practice location 1
2601 s grand canyon drive
#2080
Las Vegas, NV 89117
Phone (916) 533-4989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-0929 | NV | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1043728033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3831 W CHARLESTON BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891021859",
"telephone_number": "702-876-1733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3831 W CHARLESTON BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891021859",
"telephone_number": "702-876-1733"
}
],
"practiceLocations": [
{
"address_1": "2601 s grand canyon drive",
"address_2": "#2080",
"address_purpose": "LOCATION",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89117",
"country_code": "US",
"telephone_number": "916-533-4989",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GWINN",
"first_name": "KAREEM",
"middle_name": "JABRAUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-12",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NV",
"license": "A-0929",
"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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.