Individual provider Active NPI

Miremonde Joseph, OTD, OTR/L, CLT

  • Occupational Therapist
  • North Las Vegas, NV
National Provider Identifier
1295365344
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-2958 Issued in NV
Practice address
1550 W Craig Rd Ste 210
North Las Vegas, NV 89032-0329
Phone
(702) 360-9142
NPI assigned
Jan 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 20442 FL
Occupational Therapist 225X00000X OT-2958 NV Primary

Addresses

Primary practice location

1550 W Craig Rd Ste 210
North Las Vegas, NV 89032-0329

Mailing address

2611 NW 60TH Way
Sunrise, FL 33313-2230

Other practice location 1

2611 NW 60th Way
Sunrise, FL 33313-2230
Phone (954) 873-5209

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address joseph020@gannon.edu

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
20442FLMDOccupational Therapist
OT-2958NVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Handology, LLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1295365344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 NW 60TH WAY",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333132230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 W CRAIG RD STE 210",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320329",
            "telephone_number": "702-360-9142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2611 NW 60th Way",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333132230",
            "country_code": "US",
            "telephone_number": "954-873-5209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "MIREMONDE",
        "credential": "OTD, OTR/L, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "20442",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "OT-2958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joseph020@gannon.edu",
            "affiliation": "N",
            "address_1": "2611 NW 60th Way",
            "city": "Sunrise",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333132230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.