Individual provider Active NPI

Stacey Allison Grossman, MSPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1235459330
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1182 Issued in NV
Practice address
7324 W. Cheyenne Ave
Paragon Health Care
Las Vegas, NV 89129-0000
Phone
(702) 214-6665
NPI assigned
Jun 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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 1182 NV Primary

Addresses

Primary practice location

7324 W. Cheyenne Ave
Paragon Health Care
Las Vegas, NV 89129-0000

Mailing address

7324 W. Cheyenne Ave
Paragon Health Care
Las Vegas, NV 89129
Phone (702) 214-6665

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
1182NVMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1235459330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7324 W. CHEYENNE AVE",
            "address_2": "PARAGON HEALTH CARE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89129",
            "telephone_number": "702-214-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7324 W. CHEYENNE AVE",
            "address_2": "PARAGON HEALTH CARE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891290000",
            "telephone_number": "702-214-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "STACEY",
        "middle_name": "ALLISON",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1182",
            "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 Jun 11, 2010; 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.