Individual provider Active NPI

Madot Gebreegziabher

  • Rehabilitation Practitioner
  • Las Vegas, NV
National Provider Identifier
1710512678
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
6412 Melody Rose Ave
Las Vegas, NV 89108-7324
Phone
(702) 581-6761
NPI assigned
Mar 10, 2020
Last updated
Mar 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X NU Primary

Addresses

Primary practice location

6412 Melody Rose Ave
Las Vegas, NV 89108-7324

Mailing address

6412 Melody Rose Ave
Las Vegas, NV 89108-7324
Phone (702) 581-6761

Other practice location 1

6412 Melody Rose Ave
Las Vegas, NV 89108-7324
Phone (702) 581-6761

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": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1710512678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 MELODY ROSE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891087324",
            "telephone_number": "702-581-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6412 MELODY ROSE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891087324",
            "telephone_number": "702-581-6761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6412 Melody Rose Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891087324",
            "country_code": "US",
            "telephone_number": "702-581-6761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEBREEGZIABHER",
        "first_name": "MADOT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "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 Mar 10, 2020; 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.