Individual provider Active NPI

Roselle Santos Antikoll

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1558957340
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7027 Issued in NV
Practice address
10867 Vemoa Dr
Las Vegas, NV 89141-3896
Phone
(702) 776-5129
NPI assigned
Dec 15, 2020
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7027 NV Primary

Addresses

Primary practice location

10867 Vemoa Dr
Las Vegas, NV 89141-3896

Mailing address

10867 Vemoa Dr
Las Vegas, NV 89141-3896

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": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1558957340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10867 VEMOA DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891413896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10867 VEMOA DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891413896",
            "telephone_number": "702-776-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTIKOLL",
        "first_name": "ROSELLE",
        "middle_name": "SANTOS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "7027",
            "primary": true
        }
    ],
    "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 Jun 17, 2026; 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.