Gold Star Physical Therapy LLC

Primary specialty

Cardiopulmonary Physical TherapistTaxonomy code 2251C2600X

Legal business name

GOLD STAR PHYSICAL THERAPY LLC

Practice address

2651 Crimson Canyon Dr Ste 120
Las Vegas, NV 89128-0843

Phone

(314) 629-2150

NPI assigned

Dec 21, 2020

Organization subpart

No

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

Authorized official

Name

Faynella Marie Tiu, PT

Title

Owner

Phone

(314) 629-2150

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1336735687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 CRIMSON CANYON DR STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 CRIMSON CANYON DR STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280843",
            "telephone_number": "314-629-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD STAR PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-21",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "TIU",
        "authorized_official_first_name": "FAYNELLA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-629-2150",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251C2600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.