Active NPI
Nancy K Mulligan, P.T.
- Pediatric Physical Therapist
- Las Vegas, NV
National Provider Identifier
1619102803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1335
- Practice address
- 505 E Windmill LN
Ste 1B (255)
Las Vegas, NV 89123-1869 - Phone
- (702) 592-1704
- NPI assigned
- May 18, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 1335 | NV | |
| Pediatric Physical Therapist | 2251P0200X | 1335 | NV | Primary |
| Orthopedic Physical Therapist | 2251X0800X | 1335 | NV |
Addresses
Primary practice location
505 E Windmill LN
Ste 1B (255)
Las Vegas, NV 89123-1869
Mailing address
505 E Windmill LN
Ste 1B (255)
Las Vegas, NV 89123-1869
Phone (702) 592-1704
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 |
|---|---|---|---|
| 1335 | NV | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242604800000",
"number": "1619102803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 E WINDMILL LN",
"address_2": "STE 1B (255)",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891231869",
"telephone_number": "702-592-1704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 E WINDMILL LN",
"address_2": "STE 1B (255)",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891231869",
"telephone_number": "702-592-1704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIGAN",
"first_name": "NANCY",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-18",
"last_updated": "2009-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "NV",
"license": "1335",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NV",
"license": "1335",
"primary": true
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NV",
"license": "1335",
"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 May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.