Individual provider Active NPI

Agatha Rose Negre

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1760133391
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4496 Issued in NV
Practice address
2500 N Rainbow Blvd Apt 2061
Las Vegas, NV 89108-4545
Phone
(646) 923-1599
NPI assigned
Jan 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4496 NV Primary

Addresses

Primary practice location

2500 N Rainbow Blvd Apt 2061
Las Vegas, NV 89108-4545

Mailing address

2500 N Rainbow Blvd Apt 2061
Las Vegas, NV 89108-4545
Phone (646) 923-1599

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
4496NVMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1760133391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N RAINBOW BLVD APT 2061",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891084545",
            "telephone_number": "646-923-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N RAINBOW BLVD APT 2061",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891084545",
            "telephone_number": "646-923-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRE",
        "first_name": "AGATHA ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4496",
            "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 Jan 14, 2022; 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.