Active NPI
Nicole Gulutzan
- Occupational Therapist
- Las Vegas, NV
National Provider Identifier
1497875926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0875
- Practice address
- 1181 S Buffalo Dr
Las Vegas, NV 89117-8311 - Phone
- (702) 360-1137
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0875 | NV | Primary |
| Pediatric Occupational Therapist | 225XP0200X | 0875 | NV |
Addresses
Primary practice location
1181 S Buffalo Dr
Las Vegas, NV 89117-8311
Mailing address
8116 Winslow Ave
Las Vegas, NV 89129-7348
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0875 | NV | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190419200000",
"number": "1497875926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8116 WINSLOW AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891297348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1181 S BUFFALO DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891178311",
"telephone_number": "702-360-1137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULUTZAN",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2007-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NV",
"license": "0875",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NV",
"license": "0875",
"primary": false
}
],
"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 Sep 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.