Individual provider Active NPI

Alissa Varlamova, CCC-SLP

  • Speech-Language Pathologist
  • Las Vegas, NV
National Provider Identifier
1104448455
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2626 S Rainbow Blvd Ste 103
Las Vegas, NV 89146-5190
Phone
(310) 243-6763
NPI assigned
May 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

2626 S Rainbow Blvd Ste 103
Las Vegas, NV 89146-5190

Mailing address

2626 S Rainbow Blvd Ste 103
Las Vegas, NV 89146-5190
Phone (310) 243-6763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240226003741 NV Practitioner - Qualified Speech Language Pathologist 8527411677 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Apr 26, 2024 Accepting new patients
Balanced Therapy Services LLC Speech-Language Pathologist CurrentSince Sep 5, 2023 Accepting new patients
Bpe LLC CurrentSince Sep 1, 2023 Accepting new patients
Orthopaedic and Neurological Rehab Inc CurrentSince Apr 26, 2024 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

365 W A St
Fallon, NV 89406
Phone (775) 428-2428

2626 S Rainbow Blvd
Ste 103
Las Vegas, NV 89146
Phone (310) 243-6763

5255 Kietzke Ln
Reno, NV 89511

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

Organizations & group practices 4

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": "1588982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1104448455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 S RAINBOW BLVD STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465190",
            "telephone_number": "310-243-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 S RAINBOW BLVD STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465190",
            "telephone_number": "310-243-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARLAMOVA",
        "first_name": "ALISSA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-09",
        "last_updated": "2023-12-20",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "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 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.