Canyon Lake Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

CANYON LAKE PHYSICAL THERAPY LLC

Practice address

2980 S Jones Blvd Ste F
Las Vegas, NV 89146-5657

Phone

(702) 256-2225

NPI assigned

Aug 31, 2020

Last updated

Sep 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eric Klein, DPTNPI 1922624709

Title

Physical Therapist

Phone

(702) 375-0405

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric Andres Klein, DPT

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1922624709
  Medicare reassignment NPD Authorized official
• Kevin Nicholas Savatgy, D.C.

  • Chiropractor
  • Las Vegas, NV
  • NPI 1134378839
  NPD (past)

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1255945044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 S JONES BLVD STE F",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465657",
            "telephone_number": "702-256-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 S JONES BLVD STE F",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465657",
            "telephone_number": "702-256-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON LAKE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "702-375-0405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Canyon Dental Implant Center LLC (Canyon Dental Implants & Dentures)
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• Canyon Gate Medical Group, LLC
• Canyon Gate Medical Group, LLC
• Canyon Gate Medical Group, LLC
• Canyon Light Treatment, LLC
• Canyon Peak Behavioral Health
• Canyon Surgical Specialists LLC
• Ronetta Canyon
• Jeffrey Koichi Canzani, BCBA, RBT

• Physical Therapy Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapy Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.