Individual provider Active NPI

Harrison Golden Diep, PT, DPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1609926674
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2478 Issued in NV
Practice address
3835 S Jones Blvd
#104
Las Vegas, NV 89103-7125
Phone
(702) 880-4193
NPI assigned
Jan 11, 2007
Last updated
Sep 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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 2478 NV Primary

Addresses

Primary practice location

3835 S Jones Blvd
#104
Las Vegas, NV 89103-7125

Mailing address

4616 W Sahara Ave
#337
Las Vegas, NV 89102-3654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101228000598 NV Practitioner - Physical Therapist in Private Practice 7810093408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Las Vegas Pain Institute and Medical Center, LLCGroup PAC ID 0941256846, 8 clinicians

Practice addresses (Care Compare)

3835 S Jones Blvd
Suite 104
Las Vegas, NV 89103-2283
Phone (702) 880-4193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Pain Institute and Medical Center, LLC Physical Therapist CurrentSince Aug 18, 2010 Accepting new patients
One to One Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Trinity 5 Inc Physical Therapist PastSince Jul 5, 2020 Accepting new patients
Physical Therapy in Your Home Inc Past Accepting new patients
Comprehensive Urgent Care Past Accepting new patients
Kuhl Consulting LV Past Accepting new patients

Locations

2705 W Horizon Ridge Pkwy
Ste 120
Henderson, NV 89052

1900 N Nellis Blvd
Las Vegas, NV 89115
Phone (702) 531-6440

3835 S Jones Blvd
Ste 104
Las Vegas, NV 89103
Phone 7028804193750

4616 W Sahara Ave
#337
Las Vegas, NV 89102

8828 Mohawk St
Las Vegas, NV 89139

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBFEDD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1609926674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 W SAHARA AVE",
            "address_2": "#337",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891023654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 S JONES BLVD",
            "address_2": "#104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891037125",
            "telephone_number": "702-880-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEP",
        "first_name": "HARRISON",
        "middle_name": "GOLDEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2478",
            "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 Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.