Active NPI
Tyrone Cooley, QBA
- Behavior Analyst
- Las Vegas, NV
National Provider Identifier
1649575358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 3430 E Flamingo Rd
Suite 237
Las Vegas, NV 89121-5003 - Phone
- (702) 834-5849
- Fax
- (702) 483-6288
- NPI assigned
- Jan 11, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
3430 E Flamingo Rd
Suite 237
Las Vegas, NV 89121-5003
Mailing address
1350 E Flamingo Rd
Box 577
Las Vegas, NV 89119-5263
Phone (702) 834-5849
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9005055395 | Medicaid | NV |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Assertive Living | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Illness Community Based Residential Treatment Facility
- Las Vegas, NV
- NPI 1073750626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294704000000",
"number": "1649575358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 E FLAMINGO RD",
"address_2": "BOX 577",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891195263",
"telephone_number": "702-834-5849",
"fax_number": "702-483-6288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3430 E FLAMINGO RD",
"address_2": "SUITE 237",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891215003",
"telephone_number": "702-834-5849",
"fax_number": "702-483-6288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOLEY",
"first_name": "TYRONE",
"credential": "QBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-11",
"last_updated": "2011-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9005055395",
"state": "NV"
}
],
"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, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.