Active NPI
Lucretia Duran
- Physical Therapist
- Las Vegas, NV
National Provider Identifier
1104580737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 7455 W Washington Ave Ste 100
Las Vegas, NV 89128-4338 - Phone
- (702) 655-9456
- NPI assigned
- Oct 29, 2021
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
7455 W Washington Ave Ste 100
Las Vegas, NV 89128-4338
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4700 | NV | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635465600000",
"number": "1104580737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7455 W WASHINGTON AVE STE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891284338",
"telephone_number": "702-655-9456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURAN",
"first_name": "LUCRETIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-29",
"last_updated": "2021-10-29",
"certification_date": "2021-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"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 Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.