NPIMap

Organization Active NPI

Speech Therapy Center of Excellence, Inc.

  • Speech-Language Pathologist
  • Las Vegas, NV
National Provider Identifier
1679620934
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SPEECH THERAPY CENTER OF EXCELLENCE, INC.
Practice address
5516 S Fort Apache Rd Ste 130
Las Vegas, NV 89148-7679
Phone
(702) 641-8244
Fax
(702) 399-8255
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Authorized official

Name
Mrs. Jil Marie Gertz, MANPI 1538269451
Title
Speech Pathologist
Phone
(702) 641-8255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

5516 S Fort Apache Rd Ste 130
Las Vegas, NV 89148-7679

Mailing address

5516 S Fort Apache Rd Ste 130
Las Vegas, NV 89148-7679
Phone (702) 641-8244

Other identifiers 1

IdentifierTypeStateIssuer
100504946MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091006000417 NV Part B Supplier - Clinic/Group Practice 8325184377 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

5516 S Fort Apache Rd
Ste 130
Las Vegas, NV 89148
Phone (702) 443-2619

5552 S Fort Apache Rd
Ste 120
Las Vegas, NV 89148
Phone (702) 641-8255

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1679620934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5516 S FORT APACHE RD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487679",
            "telephone_number": "702-641-8244",
            "fax_number": "702-399-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5516 S FORT APACHE RD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487679",
            "telephone_number": "702-641-8244",
            "fax_number": "702-399-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH THERAPY CENTER OF EXCELLENCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "GERTZ",
        "authorized_official_first_name": "JIL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "702-641-8255",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504946",
            "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 Jul 16, 2020; 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.