Individual provider Active NPI

Joellyn Somberg, PT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1356577290
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1490 Issued in NV
Practice address
1161 S Valley View Blvd
Las Vegas, NV 89102-1854
Phone
(702) 486-7670
NPI assigned
Jun 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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 1490 NV Primary

Addresses

Primary practice location

1161 S Valley View Blvd
Las Vegas, NV 89102-1854

Mailing address

2936 Setting Sun St
Las Vegas, NV 89117-0656
Phone (702) 250-7621

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
1490NVMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1356577290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 SETTING SUN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891170656",
            "telephone_number": "702-250-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 S VALLEY VIEW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021854",
            "telephone_number": "702-486-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMBERG",
        "first_name": "JOELLYN",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1490",
            "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 5, 2009; 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.