NPIMap

Organization Active NPI

Mesa View Physical Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Mesquite, NV
National Provider Identifier
1487607883
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MESA VIEW PHYSICAL REHABILITATION, LLC
Practice address
1301 Bertha Howe Ave
Suite 7
Mesquite, NV 89027-7502
Phone
(702) 346-1899
Fax
(702) 346-8581
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Travis L Wakefield, MSPT
Title
Officer/Director/MSPT
Phone
(702) 346-1899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1301 Bertha Howe Ave
Suite 7
Mesquite, NV 89027-7502

Mailing address

PO Box 757
Mesquite, NV 89024-0757
Phone (702) 346-1899

Other identifiers 1

IdentifierTypeStateIssuer
100504540MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041130001008 NV Part B Supplier - Clinic/Group Practice 5496710568 Receives reassigned benefits from 10 practitioners
Practice locations: Mesquite, NV; Overton, NV

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1301 Bertha Howe Ave
Ste B
Mesquite, NV 89027

330 Falcon Ridge Pkwy
Mesquite, NV 89027

330 Falcon Ridge Pkwy
Ste 400B
Mesquite, NV 89027
Phone (702) 345-4625

830 Hafen Ln
Mesquite, NV 89027
Phone (702) 346-0800

1140 W Pioneer Blvd
Mesquite, NV 89027
Phone (702) 346-1899

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1487607883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890240757",
            "telephone_number": "702-346-1899",
            "fax_number": "702-346-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BERTHA HOWE AVE",
            "address_2": "SUITE 7",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890277502",
            "telephone_number": "702-346-1899",
            "fax_number": "702-346-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA VIEW PHYSICAL REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "WAKEFIELD",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICER/DIRECTOR/MSPT",
        "authorized_official_telephone_number": "702-346-1899",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504540",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.