NPIMap

Organization Active NPI

Good Shepherd Rehabilitation Institute

  • Physical Therapy Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1962661413
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2073 Issued in NV
Legal business name
GOOD SHEPHERD REHABILITATION INSTITUTE
Practice address
4275 Burnham Ave
Ste 255
Las Vegas, NV 89119-5488
Phone
(702) 380-1060
Fax
(702) 380-1081
NPI assigned
Jun 9, 2008
Organization subpart
Yes
Parent organization
GOOD SHEPHERD REHABILITATION CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Myra June Luy Serrano, PT
Title
PT
Phone
(702) 380-1060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2073 NV Primary

Addresses

Primary practice location

4275 Burnham Ave
Ste 255
Las Vegas, NV 89119-5488

Mailing address

4275 Burnham Ave
Ste 255
Las Vegas, NV 89119-5488
Phone (702) 380-1060

Other identifiers 1

IdentifierTypeStateIssuer
001702161MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
Good Sheperd Rebilitation5 organizations share this tax ID, including this one
Part of
Good Shepherd Rehab Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1962661413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE",
            "address_2": "STE 255",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195488",
            "telephone_number": "702-380-1060",
            "fax_number": "702-380-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE",
            "address_2": "STE 255",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195488",
            "telephone_number": "702-380-1060",
            "fax_number": "702-380-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD REHABILITATION INSTITUTE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SHEPHERD REHABILITATION CENTER",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "SERRANO",
        "authorized_official_first_name": "MYRA JUNE",
        "authorized_official_middle_name": "LUY",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "702-380-1060",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NV",
            "license": "2073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001702161",
            "state": "NV"
        }
    ],
    "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 Jun 9, 2008; 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.