Individual provider Active NPI

Stephen McCain, CNC, CPT, OLY

  • Health & Wellness Coach
  • Las Vegas, NV
National Provider Identifier
1770396103
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
License
1190351195 Issued in CA
Practice address
8744 Mesa Canogo Dr
Las Vegas, NV 89148-1433
Phone
(310) 717-8686
NPI assigned
Jan 29, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Exercise Physiologist 224Y00000X 1200502608 CA
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 171400000X 1190351195 CA Primary

Addresses

Primary practice location

8744 Mesa Canogo Dr
Las Vegas, NV 89148-1433

Mailing address

8744 Mesa Canogo Dr
Las Vegas, NV 89148-1433
Phone (310) 717-8686

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
1190351195CAMDHealth & Wellness Coach
1200502608CAMDClinical Exercise Physiologist

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1770396103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8744 MESA CANOGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481433",
            "telephone_number": "310-717-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8744 MESA CANOGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481433",
            "telephone_number": "310-717-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAIN",
        "first_name": "STEPHEN",
        "credential": "CNC, CPT, OLY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "CA",
            "license": "1200502608",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": "CA",
            "license": "1190351195",
            "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 29, 2025; 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.