Emily Rose Anderson, OTR/L
Individual provider Active NPI Occupational Therapist · North Las Vegas, NV
NPI 1891310173 · NPPES record last updated Jun 11, 2020
Key facts
- NPI
- 1891310173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT-2538 (NV)
- Practice address
- 3985 W Cheyenne Ave Ste 306
North Las Vegas, NV 89032-8907 - Phone
- (702) 515-4009
- NPI assigned
- Jun 11, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241204003895 | NV | Practitioner - Occupational Therapist in Private Practice | 7315473014 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-2538 | NV | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speakeasy Therapy Services, LLC | Occupational Therapist | Current |
Accepting new patients |
| Speakeasy Therapy Services, LLC | Occupational Therapist | Past |
Accepting new patients |
Locations
2490 Paseo Verde Pkwy
Ste 155
Henderson, NV 89074
Phone (702) 703-5540
7425 W Azure Dr
Ste 140
Las Vegas, NV 89130
Phone (702) 983-3409
3985 W Cheyenne Ave
Ste 306
North Las Vegas, NV 89032
Phone (702) 272-0230
3965 W Cheyenne Ave
Ste 101
North Las Vegas, NV 89032
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-2538 | NV | Yes |
Addresses
Primary practice location
3985 W Cheyenne Ave Ste 306
North Las Vegas, NV 89032-8907
Mailing address
23511 Aliso Creek Rd Apt 148
Aliso Viejo, CA 92656-1345
Phone (949) 838-4324
Other providers in North Las Vegas, NV
- Juan Alejandro Andasol
- Anders and Associates Physical Therapy, LLC
- Joseph Anders
- Brandon Anderson
- Courtney Noel Anderson
- Jameisha Denise Anderson
- Larry Anderson
- Matthew B. Anderson
- Ross Anderson
- Stephanie Lynn Anderson
All providers in North Las Vegas, NV · Occupational Therapist in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.