Individual provider Active NPI

Skyler Sudweeks, DPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1205366135
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3539 Issued in NV
Practice address
821 N Nellis Blvd Ste 130
Las Vegas, NV 89110-5387
Phone
(702) 452-4563
Fax
(702) 452-6704
NPI assigned
Jun 13, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3539 NV Primary

Addresses

Primary practice location

821 N Nellis Blvd Ste 130
Las Vegas, NV 89110-5387

Mailing address

821 N Nellis Blvd Ste 130
Las Vegas, NV 89110-5387
Phone (702) 452-4563

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190110001253 NV Practitioner - Physical Therapist in Private Practice 8527304617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tru Physical Therapy IncGroup PAC ID 0941245302, 5 clinicians

Practice addresses (Care Compare)

70 E Horizon Ridge Pkwy
Suite 180
Henderson, NV 89002-7937
Phone (702) 856-0422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3539NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tru Physical Therapy Inc Physical Therapist CurrentSince Nov 30, 2018 Accepting new patients

Locations

250 S Green Valley Pkwy
Henderson, NV 89012
Phone (702) 267-5800

300 S Racetrack Rd
Henderson, NV 89015

70 E Horizon Ridge Pkwy
Ste 180
Henderson, NV 89002
Phone (702) 553-7838

3530 E Flamingo Rd
Ste 115
Las Vegas, NV 89121
Phone (702) 888-2686

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205366135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 N NELLIS BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105387",
            "telephone_number": "702-452-4563",
            "fax_number": "702-452-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N NELLIS BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105387",
            "telephone_number": "702-452-4563",
            "fax_number": "702-452-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDWEEKS",
        "first_name": "SKYLER",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "3539",
            "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 Jul 21, 2022; 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.