Individual provider Active NPI

Stanley Yashio Kamimoto, MPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1356357065
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1729 Issued in NV
Practice address
3820 S Jones Blvd
Las Vegas, NV 89103-2454
Phone
(702) 731-0831
Fax
(702) 737-9697
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1729 NV Primary

Addresses

Primary practice location

3820 S Jones Blvd
Las Vegas, NV 89103-2454

Mailing address

8402 Centennial Pkwy Ste 240
Las Vegas, NV 89149-4793
Phone (702) 294-7499

Other practice location 1

8402 Centennial Pkwy Ste 240
Las Vegas, NV 89149-4793
Phone (702) 294-7499

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

Practice roles

OrganizationSpecialtyStatusNew patients
D Keith Kleven LTD Past 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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1356357065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 CENTENNIAL PKWY STE 240",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494793",
            "telephone_number": "702-294-7499",
            "fax_number": "702-294-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891032454",
            "telephone_number": "702-731-0831",
            "fax_number": "702-737-9697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8402 Centennial Pkwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494793",
            "country_code": "US",
            "telephone_number": "702-294-7499",
            "fax_number": "702-294-7494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMIMOTO",
        "first_name": "STANLEY",
        "middle_name": "YASHIO",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1729",
            "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 Sep 28, 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.