Active NPI
Eudinel Joshua Carlos Lopez, DPT
- Physical Therapist
- Las Vegas, NV
National Provider Identifier
1053023085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4889
- Practice address
- 6375 W Charleston Blvd BLDG L
Las Vegas, NV 89146-1139 - Phone
- (702) 259-1903
- NPI assigned
- Dec 21, 2022
- Last updated
- Dec 21, 2022
- 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 Therapist | 225100000X | 4889 | NV | Primary |
Addresses
Primary practice location
6375 W Charleston Blvd BLDG L
Las Vegas, NV 89146-1139
Mailing address
10310 Brooke Rise Ave
Las Vegas, NV 89166-5176
Phone (718) 687-3827
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 |
|---|---|---|---|
| 4889 | NV | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haraya Wellness LLC | Physical Therapist | Current | Accepting new patients |
| Accessible Space Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Las Vegas, NV
- NPI 1639011463
-
dba Nevada Community Enrichment Program
- Rehabilitation Clinic/Center
- Las Vegas, NV
- NPI 1053531459
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1053023085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10310 BROOKE RISE AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891665176",
"telephone_number": "718-687-3827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6375 W CHARLESTON BLVD BLDG L",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891461139",
"telephone_number": "702-259-1903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "EUDINEL JOSHUA",
"middle_name": "CARLOS",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-21",
"last_updated": "2022-12-21",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "4889",
"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 Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.