Active NPI
Mauricio Gomez, COTAIL
- Occupational Therapy Assistant
- Las Vegas, NV
National Provider Identifier
1659537025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1127
- Practice address
- 6021 W. Cheyenne Ave.
Las Vegas, NV 89108 - Phone
- (702) 396-1426
- Fax
- (702) 657-9419
- NPI assigned
- Aug 5, 2008
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1127 | NV | Primary |
Addresses
Primary practice location
6021 W. Cheyenne Ave.
Las Vegas, NV 89108
Mailing address
8105 Divernon Ave.
Las Vegas, NV 89149
Phone (702) 338-6108
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 |
|---|---|---|---|
| 1127 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217894400000",
"number": "1659537025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8105 DIVERNON AVE.",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89149",
"telephone_number": "702-338-6108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6021 W. CHEYENNE AVE.",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89108",
"telephone_number": "702-396-1426",
"fax_number": "702-657-9419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "MAURICIO",
"name_prefix": "Mr.",
"credential": "COTAIL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-05",
"last_updated": "2008-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NV",
"license": "1127",
"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 Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.