Active NPI
New Light Therapy
- Physical Disabilities Residential Treatment Facility
- Minden, NV
National Provider Identifier
1104110840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Disabilities Residential Treatment Facility
- License
- NV20101224552
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 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 DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Speech-Language Pathologist
- Las Vegas, NV
- NPI 1699150920
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.