Individual provider Active NPI

Lance A Jones, DOCTOR OF PT

  • Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1093011025
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
09-0198 Issued in NV
Practice address
3116 Port Side Dr
Las Vegas, NV 89117-2292
Phone
(702) 245-6375
NPI assigned
Feb 9, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2534 NV
Occupational Therapist 225X00000X 09-0198 NV Primary

Addresses

Primary practice location

3116 Port Side Dr
Las Vegas, NV 89117-2292

Mailing address

3116 Port Side Dr
Las Vegas, NV 89117-2292
Phone (702) 245-6375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200324004008 NV Practitioner - Physical Therapist in Private Practice 4688002694 Reassigns benefits to 1 organization
I20200504001875 NV Practitioner - Occupational Therapist in Private Practice 4688002694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3090 S Durango Dr
Las Vegas, NV 89117-9192
Phone (702) 954-4956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Life Therapy, Inc CurrentSince Jan 25, 2020 Accepting new patients

Locations

3090 S Durango Dr
#200F
Las Vegas, NV 89117
Phone (702) 954-4956

3090 S Durango Dr
Ste 200
Las Vegas, NV 89117

2465 Reynolds Ave
Ste 201
North Las Vegas, NV 89030
Phone (702) 203-1066

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": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1093011025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 PORT SIDE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172292",
            "telephone_number": "702-245-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 PORT SIDE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172292",
            "telephone_number": "702-245-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "LANCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DOCTOR OF PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-09",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2534",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "09-0198",
            "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 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.