Individual provider Active NPI

Taylor N Callahan, PTA, MT

  • Physical Therapy Assistant
  • Henderson, NV
National Provider Identifier
1154970820
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-1234 Issued in NV
Practice address
1180 E Lake Mead Pkwy
Henderson, NV 89015-5561
Phone
(702) 565-8555
NPI assigned
Sep 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-1234 NV Primary

Addresses

Primary practice location

1180 E Lake Mead Pkwy
Henderson, NV 89015-5561

Mailing address

11047 Romola St
Las Vegas, NV 89141-3410
Phone (720) 498-0748

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
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
A-1234NVMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1154970820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11047 ROMOLA ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891413410",
            "telephone_number": "720-498-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 E LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890155561",
            "telephone_number": "702-565-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "TAYLOR",
        "middle_name": "N",
        "credential": "PTA, MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-1234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.