James T Ahlstrom, PT, DPT
Individual provider Active NPI Physical Therapist · Hawthorne, NV
NPI 1669956041 · NPPES record last updated Oct 13, 2021
Key facts
- NPI
- 1669956041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 3842 (NV)
- Practice address
- 200 S a St
Hawthorne, NV 89415 - Phone
- (775) 945-2461
- NPI assigned
- Sep 20, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200403001627 | NV | Practitioner - Physical Therapist in Private Practice | 7810326386 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3842 | NV | MD | Physical Therapist |
Interoperability endpoints
- james.ahlstrom.1@11938.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3842 | NV | Yes |
Addresses
Primary practice location
200 S a St
Hawthorne, NV 89415
Mailing address
112 W 5TH St
Box 1554
Hawthorne, NV 89415-4256
Phone (208) 244-8202
Other providers in Hawthorne, NV
- 1St Clark County Medical Clinic LLC
- 1St Clark County Medical Clinic LLC
- Laura Ahlstrom
- Janae Anderson
- Guy Archambault
- Kirk Arritt
- Banner Health Physicians West LLC
All providers in Hawthorne, NV · Physical Therapist in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.