Individual provider Active NPI

Alonzo Davis

  • Rehabilitation Practitioner
  • North Las Vegas, NV
National Provider Identifier
1689968752
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
3120 Manti Peak Ave
North Las Vegas, NV 89081-6549
Phone
(702) 528-2830
NPI assigned
Jun 6, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225400000X Primary

Addresses

Primary practice location

3120 Manti Peak Ave
North Las Vegas, NV 89081-6549

Mailing address

3120 Manti Peak Ave
North Las Vegas, NV 89081-6549
Phone (702) 528-2830

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

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1689968752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 MANTI PEAK AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890816549",
            "telephone_number": "702-528-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 MANTI PEAK AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890816549",
            "telephone_number": "702-528-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ALONZO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.