Individual provider Active NPI

Shaun Crowley

  • Physical Therapy Assistant
  • Las Vegas, NV
National Provider Identifier
1326309790
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-0161 Issued in NV
Practice address
1120 N Town Center Dr Ste 120
Las Vegas, NV 89144-6302
Phone
(866) 960-7691
Fax
(866) 960-7692
NPI assigned
Jun 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-0161 NV Primary

Addresses

Primary practice location

1120 N Town Center Dr Ste 120
Las Vegas, NV 89144-6302

Mailing address

4640 Deem Dr
North Las Vegas, NV 89031-4016
Phone (702) 326-8660

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

State licenses

LicenseStateTypeSpecialty
A-0161NVMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1326309790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 DEEM DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890314016",
            "telephone_number": "702-326-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N TOWN CENTER DR STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446302",
            "telephone_number": "866-960-7691",
            "fax_number": "866-960-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWLEY",
        "first_name": "SHAUN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-01",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-0161",
            "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 1, 2012; 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.