Clinton Treadway, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA-2641 Issued in NV

Practice address

6363 S Pecos Rd Ste 103
Las Vegas, NV 89120-6291

Phone

(702) 565-5011

NPI assigned

May 19, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1205573268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7405 BURNHAM AVE APT 2015",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891231574",
            "telephone_number": "702-565-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 S PECOS RD STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891206291",
            "telephone_number": "702-565-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWAY",
        "first_name": "CLINTON",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NV",
            "license": "OTA-2641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Elizabeth Traylor, M.S. AND BCBA
• Nathaniel Traylor
• Yolanda Traylor
• Tara Traynor-Grimes
• Michael Treacy
• Edith Treadwell
• Jasmine Juval Treadwell
• Zorie Treadwell
• Tania Treasure-Romero
• Treasures Angels

• Occupational Therapy Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Occupational Therapy Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.