Vegas Fyzpt-I

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

VEGAS FYZPT-I

Practice address

1386 S Boulder Hwy Ste 100
Henderson, NV 89015-6958

Phone

(702) 818-1717

NPI assigned

Sep 6, 2024

Organization subpart

No

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

Authorized official

Name

Adam Davidson

Title

Coo

Phone

(781) 301-1597

Specialties & licenses 1

Addresses

Other names 1

• FYZICAL Therapy & Balance Centers Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Vegas Fyzpt-I

  • Physical Therapy Clinic/Center
  • Las Vegas, NV
  • NPI 1588493068

  O20241023001141

  Same enrollment

Tax ID family

Fyzical Therapy and Balance Centers2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vegas Fyzpt-I

  • Physical Therapy Clinic/Center
  • Las Vegas, NV
  • NPI 1588493068
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lawrence E Flisser, PT, MSPT

  • Physical Therapist
  • Henderson, NV
  • NPI 1447582325
  NPD
• Shane Polatis, PT, DPT

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1871909630
  NPD

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

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1386479533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 S EASTERN AVE STE 253",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891238042",
            "telephone_number": "781-301-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1386 S BOULDER HWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890156958",
            "telephone_number": "702-818-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEGAS FYZPT-I",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "781-301-1597"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL Therapy & Balance Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maryjane Josephine Vega
• Virginia Closa Vega, FNP
• Vegas Acupuncture Therapy LLC
• Vegas Behavioral Health
• Vegas Care Transit LLC
• Vegas Valley Behavioral Health
• Vegas Valley Lactation Services LLC
• Vegas Vip Home Care LLC
• Vegas Vip Home Care LLC
• Vegas Vip Home Care LLC

• Physical Therapy Clinic/Center in Henderson, NV
• Providers in Henderson, NV by specialty
• Physical Therapy Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.