Individual provider Active NPI

Joe Rabin

  • Assisted Living Facility
  • Las Vegas, NV
National Provider Identifier
1679146872
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
9577-AGC-1 Issued in NV
Practice address
1680 Sombrero Dr
Las Vegas, NV 89169-2564
Phone
(702) 209-2580
Fax
(702) 202-4093
NPI assigned
Jul 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 9577-AGC-1 NV Primary

Addresses

Primary practice location

1680 Sombrero Dr
Las Vegas, NV 89169-2564

Mailing address

1680 Sombrero Dr
Las Vegas, NV 89169-2564
Phone (702) 209-2580

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

LicenseStateTypeSpecialty
9577-AGC-1NVMDAssisted Living Facility

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1679146872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 SOMBRERO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692564",
            "telephone_number": "702-209-2580",
            "fax_number": "702-202-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 SOMBRERO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692564",
            "telephone_number": "702-209-2580",
            "fax_number": "702-202-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABIN",
        "first_name": "JOE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NV",
            "license": "9577-AGC-1",
            "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 Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.