Organization Active NPI

New Light Therapy

  • Physical Disabilities Residential Treatment Facility
  • Minden, NV
National Provider Identifier
1104110840
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
License
NV20101224552 Issued in NV
Legal business name
NEW LIGHT THERAPY
Practice address
2869 Esaw St
Minden, NV 89423-9059
Phone
(775) 235-8809
Fax
(775) 420-4675
NPI assigned
May 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Erin Vaillancourt, D.P.T.
Title
Physical Therapist
Phone
(775) 235-8809

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Physical Disabilities Residential Treatment Facility 320700000X NV20101224552 NV Primary

Addresses

Primary practice location

2869 Esaw St
Minden, NV 89423-9059

Mailing address

1329 Hwy 395
Suite 10-274
Gardnerville, NV 89410
Phone (775) 235-8809

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1104110840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 HWY 395",
            "address_2": "SUITE 10-274",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "89410",
            "telephone_number": "775-235-8809",
            "fax_number": "775-420-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2869 ESAW ST",
            "city": "MINDEN",
            "state": "NV",
            "postal_code": "894239059",
            "telephone_number": "775-235-8809",
            "fax_number": "775-420-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIGHT THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-28",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "VAILLANCOURT",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "775-235-8809",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NV",
            "license": "NV20101224552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minden, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.