Individual provider Active NPI

Gary Lewis Johnson

  • Rehabilitation Practitioner
  • Las Vegas, NV
National Provider Identifier
1568709798
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
9322 Dorrell LN
9322 Dorrell Lane
Las Vegas, NV 89149-0172
Phone
(702) 267-0450
Fax
(702) 272-0408
NPI assigned
Jan 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

9322 Dorrell LN
9322 Dorrell Lane
Las Vegas, NV 89149-0172

Mailing address

9322 Dorrell LN
9322 Dorrell Lane
Las Vegas, NV 89149-0172
Phone (702) 267-0450

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": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1568709798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9322 DORRELL LN",
            "address_2": "9322 DORRELL LANE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490172",
            "telephone_number": "702-267-0450",
            "fax_number": "702-272-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9322 DORRELL LN",
            "address_2": "9322 DORRELL LANE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490172",
            "telephone_number": "702-267-0450",
            "fax_number": "702-272-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARY",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "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 Jan 8, 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.

Verify at the official NPI Registry.