NPIMap

Individual provider Active NPI

Lauren Dinicola, PHYSICAL THERAPIST,

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1679729537
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2253 Issued in NV
Practice address
3650 S. Eastern Avenue
Suite 100
Las Vegas, NV 89169-3345
Phone
(702) 731-6873
Fax
(702) 731-2565
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2253 NV Primary

Addresses

Primary practice location

3650 S. Eastern Avenue
Suite 100
Las Vegas, NV 89169-3345

Mailing address

3650 S. Eastern Avenue
Suite 100
Las Vegas, NV 89169-3345
Phone (702) 731-6873

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clark County Medical Group LLC PastSince Feb 23, 2018 Accepting new patients
Jack D. Close and Associates Physical Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1679729537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 S. EASTERN AVENUE",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693345",
            "telephone_number": "702-731-6873",
            "fax_number": "702-731-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 S. EASTERN AVENUE",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693345",
            "telephone_number": "702-731-6873",
            "fax_number": "702-731-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINICOLA",
        "first_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2253",
            "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 Dec 16, 2009; 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.