Individual provider Active NPI

Jeremy Thompson, P.T,

  • Pediatric Occupational Therapist
  • Henderson, NV
National Provider Identifier
1679806608
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
090170 Issued in NV
Practice address
2780 W Horizon Ridge Pkwy
Ste 40
Henderson, NV 89052-3995
Phone
(702) 564-4116
Fax
(702) 932-2403
NPI assigned
Sep 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 090170 NV Primary

Addresses

Primary practice location

2780 W Horizon Ridge Pkwy
Ste 40
Henderson, NV 89052-3995

Mailing address

2780 W Horizon Ridge Pkwy
Ste 40
Henderson, NV 89052-3995
Phone (702) 564-4116

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
090170NVMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc Past Accepting new patients

Organizations & group practices 1

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": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1679806608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 W HORIZON RIDGE PKWY",
            "address_2": "STE 40",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523995",
            "telephone_number": "702-564-4116",
            "fax_number": "702-932-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 W HORIZON RIDGE PKWY",
            "address_2": "STE 40",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523995",
            "telephone_number": "702-564-4116",
            "fax_number": "702-932-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JEREMY",
        "name_prefix": "Mr.",
        "credential": "P.T,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NV",
            "license": "090170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.