Active NPI
Kevin Patrick Minchin
- Physical Therapist
- Las Vegas, NV
National Provider Identifier
1093221947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3612
- Practice address
- 2235 E Flamingo Rd Ste 170
Las Vegas, NV 89119-5186 - Phone
- (702) 893-3333
- Fax
- (702) 893-0960
- NPI assigned
- Dec 14, 2017
- 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 | 3612 | NV | Primary |
Addresses
Primary practice location
2235 E Flamingo Rd Ste 170
Las Vegas, NV 89119-5186
Mailing address
PO Box 777851
Henderson, NV 89077-7851
Phone (702) 893-3333
Other practice location 1
2821 W Horizon Ridge Pkwy Ste 101
Henderson, NV 89052-4429
Phone (702) 893-3333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1702161 | Medicaid | NV |
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 |
|---|---|---|---|
| 3612 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1093221947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 777851",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890777851",
"telephone_number": "702-893-3333",
"fax_number": "702-893-0960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2235 E FLAMINGO RD STE 170",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891195186",
"telephone_number": "702-893-3333",
"fax_number": "702-893-0960"
}
],
"practiceLocations": [
{
"address_1": "2821 W Horizon Ridge Pkwy Ste 101",
"address_purpose": "LOCATION",
"city": "Henderson",
"state": "NV",
"postal_code": "890524429",
"country_code": "US",
"telephone_number": "702-893-3333",
"fax_number": "702-893-0960",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MINCHIN",
"first_name": "KEVIN",
"middle_name": "PATRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-14",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "3612",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1702161",
"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 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.