Individual provider Active NPI

Carl Jamerson II

  • Rehabilitation Practitioner
  • Las Vegas, NV
National Provider Identifier
1770874174
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
2101 Sunland Ave
Las Vegas, NV 89106-3968
Phone
(702) 336-1912
NPI assigned
Apr 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225400000X Primary

Addresses

Primary practice location

2101 Sunland Ave
Las Vegas, NV 89106-3968

Mailing address

2101 Sunland Ave
Las Vegas, NV 89106-3968
Phone (702) 336-1912

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

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1770874174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 SUNLAND AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063968",
            "telephone_number": "702-336-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 SUNLAND AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063968",
            "telephone_number": "702-336-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMERSON",
        "first_name": "CARL",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "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 Apr 20, 2011; 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.