Active NPI
Leigh Wilfred Kotkov, PH.D.
- Psychologist
- Las Vegas, NV
National Provider Identifier
1265591184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PYO392
- Practice address
- 5720 El Parque
Las Vegas, NV 89146 - Phone
- (702) 219-1442
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PYO392 | NV | Primary |
Addresses
Primary practice location
5720 El Parque
Las Vegas, NV 89146
Mailing address
5720 El Parque
Las Vegas, NV 89146
Phone (702) 219-1442
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PYO392 | NV | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265591184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5720 EL PARQUE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89146",
"telephone_number": "702-219-1442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5720 EL PARQUE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89146",
"telephone_number": "702-219-1442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTKOV",
"first_name": "LEIGH",
"middle_name": "WILFRED",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NV",
"license": "PYO392",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.