Skyshroud Home Health Corp

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SKYSHROUD HOME HEALTH CORP

Practice address

5480 Cold Lake St
Las Vegas, NV 89148-7609

Phone

(702) 289-9797

NPI assigned

Apr 25, 2024

Organization subpart

No

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

Authorized official

Name

Saint Don Niel Bautista Reyes, PT, ATPNPI 1457804239

Title

Ceo

Phone

(702) 289-9797

Specialties & licenses 2

Addresses

Other identifiers 3

Practitioners 1

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

• Saint Don Niel Bautista Reyes, PT, ATP

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1457804239
  NPD Authorized official

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1497501019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 COLD LAKE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487609",
            "telephone_number": "702-289-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 COLD LAKE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487609",
            "telephone_number": "702-289-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYSHROUD HOME HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "SAINT DON NIEL",
        "authorized_official_middle_name": "BAUTISTA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-289-9797",
        "authorized_official_credential": "PT, ATP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750957148",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447850318",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457804239",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.