NPIMap

Organization Active NPI

Phenom Speech Therapy, LLC

  • Speech-Language Pathologist
  • Las Vegas, NV
National Provider Identifier
1265727598
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-1264 Issued in NV
Legal business name
PHENOM SPEECH THERAPY, LLC
Practice address
9937 Delicate Dew St
Las Vegas, NV 89183-7153
Phone
(702) 985-8385
NPI assigned
Jun 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Authorized official

Name
Corrie Rilling, M.S., CCC-SLPNPI 1710154802
Title
Owner/Manager
Phone
(208) 919-4189

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SP-1264 NV Primary

Addresses

Primary practice location

9937 Delicate Dew St
Las Vegas, NV 89183-7153

Mailing address

9850 S Maryland Pkwy
Ste a-5 #264
Las Vegas, NV 89183-7146
Phone (702) 985-8385

National Provider Directory

National Provider Directory

Locations

9850 S Maryland Pkwy
Ste A5
Las Vegas, NV 89183
Phone (702) 401-4017

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1265727598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 S MARYLAND PKWY",
            "address_2": "STE A-5 #264",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837146",
            "telephone_number": "702-985-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9937 DELICATE DEW ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837153",
            "telephone_number": "702-985-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHENOM SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "RILLING",
        "authorized_official_first_name": "CORRIE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "208-919-4189",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP-1264",
            "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 15, 2011; 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.