Individual provider Active NPI

Renelie Suba Khoury, RT

  • Certified Respiratory Therapist
  • Las Vegas, NV
National Provider Identifier
1730402967
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Respiratory TherapistTaxonomy code 227800000X
License
RC#1717 Issued in NV
Practice address
6070 S. Fort Apache Rd.
Suite 110
Las Vegas, NV 89148
Phone
(702) 839-1114
Fax
(702) 380-1081
NPI assigned
Mar 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Respiratory Therapist 227800000X RC#1717 NV Primary

Addresses

Primary practice location

6070 S. Fort Apache Rd.
Suite 110
Las Vegas, NV 89148

Mailing address

P.O. Box 777851
Henderson, NV 89077-7851
Phone (702) 839-1114

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
RC#1717NVMDCertified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Shepherd Rehab Centers of Las Vegas Inc PastSince Jan 1, 2021 Accepting new patients
Good Shepherd Hospice Care Inc PastSince Jan 1, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1730402967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 777851",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890777851",
            "telephone_number": "702-839-1114",
            "fax_number": "702-380-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 S. FORT APACHE RD.",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89148",
            "telephone_number": "702-839-1114",
            "fax_number": "702-380-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "RENELIE",
        "middle_name": "SUBA",
        "credential": "RT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2024-06-07",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": "NV",
            "license": "RC#1717",
            "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 7, 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.