Individual provider Active NPI

Ryan Steven Perez-Carrillo, CCC-SLP

  • Speech-Language Pathologist
  • Las Vegas, NV
National Provider Identifier
1043923519
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-3551 Issued in NV
Practice address
7121 W Craig Rd Ste 113-1207
Las Vegas, NV 89129-6001
Phone
(702) 527-3142
Fax
(702) 549-7717
NPI assigned
Dec 29, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 36625 CA
Speech-Language Pathologist 235Z00000X SP-3551 NV Primary

Addresses

Primary practice location

7121 W Craig Rd Ste 113-1207
Las Vegas, NV 89129-6001

Mailing address

7450 W Cheyenne Ave
Suite 103 PMB 1261
Las Vegas, NV 89129-1592
Phone (702) 527-3142

Other identifiers 1

IdentifierTypeStateIssuer
250024774MedicaidNV

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

LicenseStateTypeSpecialty
36625CAMDSpeech-Language Pathologist
SP-3551NVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Not Too Little Speech Therapy, LLC Single Specialty CurrentSince May 7, 2024 Accepting new patients

Locations

7450 W Cheyenne Ave
Ste 103
Las Vegas, NV 89129
Phone (702) 329-0435

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1043923519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 W CHEYENNE AVE",
            "address_2": "SUITE 103 PMB 1261",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891291592",
            "telephone_number": "702-527-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7121 W CRAIG RD STE 113-1207",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296001",
            "telephone_number": "702-527-3142",
            "fax_number": "702-549-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-CARRILLO",
        "first_name": "RYAN",
        "middle_name": "STEVEN",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-29",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "36625",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP-3551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250024774",
            "state": "NV"
        }
    ],
    "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 Apr 30, 2024; 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.