Organization Active NPI

Good Shepherd Rehabilitation Institute Inc.

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1164605044
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GOOD SHEPHERD REHABILITATION INSTITUTE INC.
Practice address
2235 E Flamingo Rd Ste 170
Las Vegas, NV 89119-5186
Phone
(725) 333-7149
Fax
(702) 893-0960
NPI assigned
Dec 13, 2007
Last updated
Apr 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Authorized official

Name
Mr. Raul A Abejuela
Title
President/Ceo
Phone
(702) 893-3333

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Cardiopulmonary Physical Therapist 2251C2600X

Addresses

Primary practice location

2235 E Flamingo Rd Ste 170
Las Vegas, NV 89119-5186

Mailing address

P.O. Box 777851
Henderson, NV 89077
Phone (702) 893-3333

Other identifiers 1

IdentifierTypeStateIssuer
1702161MedicaidNV

National Provider Directory

National Provider Directory

Locations

4640 W Craig Rd
North Las Vegas, NV 89032
Phone (702) 433-6971

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1164605044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 777851",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89077",
            "telephone_number": "702-893-3333",
            "fax_number": "702-893-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 E FLAMINGO RD STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195186",
            "telephone_number": "725-333-7149",
            "fax_number": "702-893-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD REHABILITATION INSTITUTE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "ABEJUELA",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "702-893-3333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251C2600X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702161",
            "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 Apr 18, 2018; 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.