Active NPI
Reggie Anderson
- Rehabilitation Practitioner
- Las Vegas, NV
National Provider Identifier
1508169137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 4278 Cartegena Way
Las Vegas, NV 89121-6504 - Phone
- (702) 433-6468
- NPI assigned
- Dec 21, 2010
- Last updated
- Jan 28, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | NU | Primary | |
| Community Health Worker | 172V00000X | NU |
Addresses
Primary practice location
4278 Cartegena Way
Las Vegas, NV 89121-6504
Mailing address
4278 Cartegena Way
Las Vegas, NV 89121-6504
Phone (702) 283-0675
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359331200000",
"number": "1508169137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4278 CARTEGENA WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891216504",
"telephone_number": "702-283-0675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4278 CARTEGENA WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891216504",
"telephone_number": "702-433-6468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "REGGIE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-21",
"last_updated": "2013-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NU",
"license": null,
"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 Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.