Anngie May Axalan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

7060 N Durango Dr Ste 130
Las Vegas, NV 89149-4605

Phone

(702) 826-5749

Fax

(702) 273-3015

NPI assigned

Jul 9, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Anngie May Lagare Enriquez Other name

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New Century Rehabilitation LLC

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1396777892

  NV, Physical Therapist

  Medicare reassignment NPD
• New Century Rehabilitation, LLC

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
  • NPI 1801471628
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708214400000",
    "number": "1669968012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7060 N DURANGO DR STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494605",
            "telephone_number": "702-826-5749",
            "fax_number": "702-273-3015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3999 Venoy Rd",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "MI",
            "postal_code": "481841485",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8144 Jeremy Rd",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "MI",
            "postal_code": "481115382",
            "country_code": "US",
            "telephone_number": "734-709-3660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8144 Jeremy Rd",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "MI",
            "postal_code": "481115382",
            "country_code": "US",
            "telephone_number": "734-709-3660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8144 Jeremy Rd",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "MI",
            "postal_code": "481115382",
            "country_code": "US",
            "telephone_number": "734-709-3660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AXALAN",
        "first_name": "ANNGIE MAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2024-02-18",
        "certification_date": "2024-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013950",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNGIE MAY",
            "last_name": "ENRIQUEZ",
            "middle_name": "LAGARE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Las Vegas, NV
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.