Individual provider Active NPI

Shauna J Mullenix, PT

  • Physical Therapist
  • Pahrump, NV
National Provider Identifier
1215209655
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2632 Issued in NV
Practice address
1470 E Calvada Blvd
Suite 100
Pahrump, NV 89048-3905
Phone
(775) 537-2300
Fax
(775) 537-2345
NPI assigned
Feb 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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 2632 NV Primary

Addresses

Primary practice location

1470 E Calvada Blvd
Suite 100
Pahrump, NV 89048-3905

Mailing address

1655 W Horizon Ridge Pkwy
Suite 100
Henderson, NV 89012-3494
Phone (702) 914-2790

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
2632NVMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: shersey32715@direct.bilh.masshiway.net

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1215209655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 W HORIZON RIDGE PKWY",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890123494",
            "telephone_number": "702-914-2790",
            "fax_number": "702-914-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 E CALVADA BLVD",
            "address_2": "SUITE 100",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890483905",
            "telephone_number": "775-537-2300",
            "fax_number": "775-537-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLENIX",
        "first_name": "SHAUNA",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahrump, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.