Individual provider Active NPI

Christina Kim

  • Physical Therapy Assistant
  • Henderson, NV
National Provider Identifier
1174276273
Registry record updated Apr 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-1378 Issued in NV
Practice address
1590 W Sunset Rd # 110
Henderson, NV 89014-6633
Phone
(702) 818-5000
NPI assigned
Jan 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2022

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-1378 NV Primary

Addresses

Primary practice location

1590 W Sunset Rd # 110
Henderson, NV 89014-6633

Mailing address

1590 W Sunset Rd # 110
Henderson, NV 89014-6633
Phone (702) 818-5000

Other practice location 1

8925 W Russell Rd Ste 140
Las Vegas, NV 89148-1220
Phone (702) 914-6787

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

State licenses

LicenseStateTypeSpecialty
A-1378NVMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Las Fyzical LLC PastSince Apr 17, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649548800000",
    "number": "1174276273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 W SUNSET RD # 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890146633",
            "telephone_number": "702-818-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 W SUNSET RD # 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890146633",
            "telephone_number": "702-818-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8925 W Russell Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891481220",
            "country_code": "US",
            "telephone_number": "702-914-6787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-04-10",
        "certification_date": "2022-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-1378",
            "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 Apr 10, 2022; 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.