Individual provider Active NPI

Tiana Marie Vernooy

  • Rehabilitation Practitioner
  • Las Vegas, NV
National Provider Identifier
1396018578
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
2349 Renaissance Dr
Suite a
Las Vegas, NV 89119-6191
Phone
(702) 739-7716
Fax
(702) 597-2242
NPI assigned
Feb 17, 2012
Last updated
Feb 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

2349 Renaissance Dr
Suite a
Las Vegas, NV 89119-6191

Mailing address

200 N Pecos Rd TRLR 62
Las Vegas, NV 89101-4867
Phone (559) 355-8444

Other names 1

  • Tiana Marie Kellogg Former 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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Childrens Services 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1396018578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N PECOS RD TRLR 62",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891014867",
            "telephone_number": "559-355-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 RENAISSANCE DR",
            "address_2": "SUITE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196191",
            "telephone_number": "702-739-7716",
            "fax_number": "702-597-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNOOY",
        "first_name": "TIANA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIANA",
            "last_name": "KELLOGG",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former 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 Feb 17, 2012; 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.