Individual provider Active NPI

Jose Luis Clemente, PT

  • Physical Therapist
  • Henderson, NV
National Provider Identifier
1689498263
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1491 Issued in NV
Practice address
2821 W Horizon Ridge Pkwy Ste 101
Henderson, NV 89052-4429
Phone
(725) 333-7124
Fax
(702) 893-0960
NPI assigned
Nov 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 1491 NV Primary

Addresses

Primary practice location

2821 W Horizon Ridge Pkwy Ste 101
Henderson, NV 89052-4429

Mailing address

2821 W Horizon Ridge Pkwy Ste 101
Henderson, NV 89052-4429
Phone (725) 333-7124

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
1491NVMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1689498263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 W HORIZON RIDGE PKWY STE 101",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524429",
            "telephone_number": "725-333-7124",
            "fax_number": "702-893-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 W HORIZON RIDGE PKWY STE 101",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524429",
            "telephone_number": "725-333-7124",
            "fax_number": "702-893-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "JOSE LUIS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1491",
            "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 Nov 11, 2024; 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.