NPIMap

Organization Active NPI

Good Life Therapy, LLC

  • Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1700211182
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
130363 Issued in NV
Legal business name
GOOD LIFE THERAPY, LLC
Practice address
850 La Sconsa Dr
Las Vegas, NV 89138-7562
Phone
(702) 526-5550
Fax
(702) 347-7649
NPI assigned
Sep 4, 2013
Last updated
Jun 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Authorized official

Name
Corinne Trenholm, OTR/LNPI 1437585064
Title
Owner/Manager
Phone
(702) 526-5550

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
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 130363 NV Primary

Addresses

Primary practice location

850 La Sconsa Dr
Las Vegas, NV 89138-7562

Mailing address

850 La Sconsa Dr
Las Vegas, NV 89138-7562
Phone (702) 526-5550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140731002448 NV Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5890911507 Receives reassigned benefits from 5 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1700211182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 LA SCONSA DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891387562",
            "telephone_number": "702-526-5550",
            "fax_number": "702-347-7649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 LA SCONSA DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891387562",
            "telephone_number": "702-526-5550",
            "fax_number": "702-347-7649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-04",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "TRENHOLM",
        "authorized_official_first_name": "CORINNE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "702-526-5550",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "130363",
            "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 Jun 1, 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.