NPIMap

Individual provider Active NPI

Jade Madison, OTR/L

  • Pediatric Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1326326174
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
10-0057 Issued in NV
Practice address
5375 Pendini Point CT
Las Vegas, NV 89141-0419
Phone
(702) 499-0443
Fax
(702) 726-9527
NPI assigned
Jul 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 10-0057 NV
Pediatric Occupational Therapist 225XP0200X 10-0057 NV Primary
Physical Rehabilitation Occupational Therapist 225XP0019X 10-0057 NV

Addresses

Primary practice location

5375 Pendini Point CT
Las Vegas, NV 89141-0419

Mailing address

5375 Pendini Point CT
Las Vegas, NV 89141-0419
Phone (702) 499-0443

Other names 1

  • Irina Sobyanina Other name

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
10-0057NVMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
My Family Home Health LLC CurrentSince Apr 19, 2019 Accepting new patients
Jade Madison Therapy LLC Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1326326174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5375 PENDINI POINT CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891410419",
            "telephone_number": "702-499-0443",
            "fax_number": "702-726-9527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5375 PENDINI POINT CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891410419",
            "telephone_number": "702-499-0443",
            "fax_number": "702-726-9527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON",
        "first_name": "JADE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "10-0057",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NV",
            "license": "10-0057",
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NV",
            "license": "10-0057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRINA",
            "last_name": "SOBYANINA",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 11, 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.