Individual provider Active NPI

Reagan Elizabeth Knoblauch

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1760940894
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
IC-1053 Issued in NV
Practice address
1830 E Sahara Ave Ste 210
Las Vegas, NV 89104-3739
Phone
(702) 383-8073
NPI assigned
Mar 7, 2019
Last updated
Mar 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IC-1053 NV Primary

Addresses

Primary practice location

1830 E Sahara Ave Ste 210
Las Vegas, NV 89104-3739

Mailing address

6333 Cromwell Ave
Las Vegas, NV 89107-2566
Phone (702) 561-2183

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
IC-1053NVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1760940894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 CROMWELL AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072566",
            "telephone_number": "702-561-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 E SAHARA AVE STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043739",
            "telephone_number": "702-383-8073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOBLAUCH",
        "first_name": "REAGAN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "IC-1053",
            "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 7, 2019; 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.