Active NPI
Jennifer Willey
- Physical Therapist
- Las Vegas, NV
National Provider Identifier
1629660436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 7125 Grand Montecito Pkwy Ste 120
Las Vegas, NV 89149-0261 - Phone
- (702) 637-2703
- NPI assigned
- Feb 3, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | NV | ||
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
7125 Grand Montecito Pkwy Ste 120
Las Vegas, NV 89149-0261
Mailing address
9617 Stoney Mesa CT
Las Vegas, NV 89139-7403
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1629660436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9617 STONEY MESA CT",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891397403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7125 GRAND MONTECITO PKWY STE 120",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891490261",
"telephone_number": "702-637-2703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLEY",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-03",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NV",
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"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 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.