Individual provider Active NPI

Luke Gaughan, OT

  • Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1164537221
Registry record updated Jan 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
4000 S Eastern Ave Ste 150
Las Vegas, NV 89119-0840
Phone
(725) 726-7847
Fax
(725) 726-7876
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

4000 S Eastern Ave Ste 150
Las Vegas, NV 89119-0840

Mailing address

10785 W Twain Ave Ste 250
Las Vegas, NV 89135-3026
Phone (725) 726-7847

Other identifiers 1

IdentifierTypeStateIssuer
0295OtherNVLICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110323000710 NV Practitioner - Occupational Therapist in Private Practice 8224211586 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smith Therapy PartnersGroup PAC ID 1052731072, 46 clinicians

Practice addresses (Care Compare)

2879 Saint Rose Pkwy
Suite 110
Henderson, NV 89052-4808
Phone (725) 726-7847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Rehabilitation LLC Occupational Therapist CurrentSince Apr 23, 2015 Accepting new patients
New Century Rehabilitation, LLC CurrentSince Apr 23, 2015 Accepting new patients
Smith Therapy Partners CurrentSince Jan 25, 2021 Accepting new patients
Sunrise Mountainview Hospital, Inc. PastSince Feb 7, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2879 Saint Rose Pkwy
Ste 110
Henderson, NV 89052
Phone (702) 896-3444

1505 Wigwam Pkwy
Ste 240
Henderson, NV 89074
Phone (702) 568-0195

10040 Alta Dr
Ste 230
Las Vegas, NV 89145
Phone (725) 726-7947

2820 W Charleston Blvd
Ste 1
Las Vegas, NV 89102

4000 S Eastern Ave
Ste 300
Las Vegas, NV 89119
Phone (702) 734-2732

4000 S Eastern Ave
Ste 150
Las Vegas, NV 89119
Phone (702) 476-0262

10785 W Twain Ave
Ste 250
Las Vegas, NV 89135

1950 E Desert Inn Rd
Las Vegas, NV 89169
Phone (702) 735-1501

727 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 459-4900

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611964800000",
    "number": "1164537221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10785 W TWAIN AVE STE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891353026",
            "telephone_number": "725-726-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 S EASTERN AVE STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891190840",
            "telephone_number": "725-726-7847",
            "fax_number": "725-726-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUGHAN",
        "first_name": "LUKE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-01-30",
        "certification_date": "2021-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "0295",
            "state": "NV"
        }
    ],
    "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 Jan 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.