Active NPI
Jason Molino, PERSONAL TRAINER
- Clinical Exercise Physiologist
- Nixon, NV
National Provider Identifier
1558622159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Exercise Physiologist
- License
- 1051942
- Practice address
- 705 Highway 446
Nixon, NV 89424-0117 - Phone
- (775) 574-1018
- Fax
- (775) 574-1114
- NPI assigned
- May 31, 2012
- Last updated
- Jan 6, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | 1064500 | NV | |
| Clinical Exercise Physiologist | 224Y00000X | 1051942 | NV | Primary |
Addresses
Primary practice location
705 Highway 446
Nixon, NV 89424-0117
Mailing address
P.O. Box 227
Nixon, NV 89424-0117
Phone (775) 574-1018
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 |
|---|---|---|---|
| 1051942 | NV | MD | Clinical Exercise Physiologist |
| 1064500 | NV | MD | Health Service Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1558622159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 227",
"city": "NIXON",
"state": "NV",
"postal_code": "894240117",
"telephone_number": "775-574-1018",
"fax_number": "775-574-1114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 HIGHWAY 446",
"city": "NIXON",
"state": "NV",
"postal_code": "894240117",
"telephone_number": "775-574-1018",
"fax_number": "775-574-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLINO",
"first_name": "JASON",
"name_prefix": "Mr.",
"credential": "PERSONAL TRAINER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-31",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "NV",
"license": "1064500",
"primary": false
},
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": "NV",
"license": "1051942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nixon, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.