Jon G Requena

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

8916 Crystal Coral Way
Las Vegas, NV 89123-3141

Phone

(702) 782-8557

NPI assigned

Oct 15, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1992015507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8916 CRYSTAL CORAL WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233141",
            "telephone_number": "702-782-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8916 CRYSTAL CORAL WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233141",
            "telephone_number": "702-782-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REQUENA",
        "first_name": "JON",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tirso Repalda
• Lauren Repici
• Brandon Repko, M.D.
• Sarah Elizabeth Reppe
• Dominique Requejo
• Jonathan Requenes
• Lilia Patricia Requenes
• Norma Lucero Requenes
• Perpetual Par Requerque
• Aniuska Requesen

• Rehabilitation Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Rehabilitation Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.