Jeremy Juhani Kokkonen, DO

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

007204 Issued in AZ

Practice address

620 Shadow Lane
Las Vegas, NV 89106-4194

Phone

(702) 388-4000

Fax

(702) 388-8431

NPI assigned

May 29, 2008

Last updated

Apr 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Ev Pain Specialists

  • Medical Specialty Clinic/Center
  • Peoria, AZ
  • NPI 1952654154
  NPD (past)
• Nextpain Medical PA

  dba NextPain Care

  • Pain Medicine Physician
  • Lawrenceville, GA
  • NPI 1295564334

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1750549424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 WOODSTEAD CT",
            "address_2": "STE 208",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801480",
            "telephone_number": "877-749-7428",
            "fax_number": "512-628-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LANE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064194",
            "telephone_number": "702-388-4000",
            "fax_number": "702-388-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKKONEN",
        "first_name": "JEREMY",
        "middle_name": "JUHANI",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": "SL0518",
            "primary": false
        },
        {
            "code": "193200000X",
            "taxonomy_group": "",
            "desc": "Multi-Specialty",
            "state": "HI",
            "license": "DO-1245",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WY",
            "license": "11025A",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "007204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda J Koiro
• Maria Kojokian
• Govind V Koka, DO
• Ani Kokikyan
• Christopher Kokkinis
• Daniel T Kokmeyer, MD
• Julie S Kokoczka, RN, BSN
• Malachi Kokoszka
• John Mark Aidan Kokowsky
• Charisse Lachica Kokseng, NP-C, WCS-C, EDS-C

• Physical Medicine & Rehabilitation Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Medicine & Rehabilitation Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.