Individual provider Active NPI

Brooke Dena Conway-Kleven, PT, DPT, PHDC

  • Physical Therapist
  • Henderson, NV
National Provider Identifier
1770068058
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3766 Issued in NV
Practice address
170 S Green Valley Pkwy Ste 300
Henderson, NV 89012-3145
Phone
(775) 720-2600
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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 3766 NV Primary

Addresses

Primary practice location

170 S Green Valley Pkwy Ste 300
Henderson, NV 89012-3145

Mailing address

170 S Green Valley Pkwy Ste 300
Henderson, NV 89012-3145

Other practice location 1

1 Breakthrough Way
Las Vegas, NV 89135-3011
Phone (702) 732-1493

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3766NVMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1770068058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 S GREEN VALLEY PKWY STE 300",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890123145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 S GREEN VALLEY PKWY STE 300",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890123145",
            "telephone_number": "775-720-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Breakthrough Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891353011",
            "country_code": "US",
            "telephone_number": "702-732-1493",
            "fax_number": "702-732-1080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONWAY-KLEVEN",
        "first_name": "BROOKE",
        "middle_name": "DENA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, PHDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "3766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.