Derek D. Ronnebaum

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2838 Issued in NV

Practice address

8751 W Charleston Blvd
#270
Las Vegas, NV 89117-5480

Phone

(702) 982-2232

Fax

(702) 982-2237

NPI assigned

Jun 26, 2013

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)

Enrolled

State licenses

Practice roles

Locations

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

• Integrated Health and Wellness Center LLC

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1790222362
  NPD
• Food Connection LLC

  • Registered Dietitian
  • Las Vegas, NV
  • NPI 1841632866
  NPD (past)

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1245670975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8751 W CHARLESTON BLVD",
            "address_2": "#270",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175480",
            "telephone_number": "702-982-2232",
            "fax_number": "702-982-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8751 W CHARLESTON BLVD",
            "address_2": "#270",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175480",
            "telephone_number": "702-982-2232",
            "fax_number": "702-982-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONNEBAUM",
        "first_name": "DEREK",
        "middle_name": "D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmin Rondon
• Roxana Rondon
• Ronette Cyka, M.D., LTD
• Katie Marie Ronis, PHARMD
• Brittany Ronnebaum, PT, DPT
• Alex Ronquillo
• Betty Ronquillo
• Desiree Ronquillo
• Caitlyn Rood
• Mariya Rood

• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.