Active NPI
Donald Ray Wilson
- Rehabilitation Practitioner
- North Las Vegas, NV
National Provider Identifier
1992200307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 3920 W Ann Rd Ste 100
North Las Vegas, NV 89031-3840 - Phone
- (702) 550-6700
- NPI assigned
- Mar 27, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
3920 W Ann Rd Ste 100
North Las Vegas, NV 89031-3840
Mailing address
3920 W Ann Rd Ste 100
North Las Vegas, NV 89031-3840
Phone (702) 550-6700
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Agency LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522108800000",
"number": "1992200307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3920 W ANN RD STE 100",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890313840",
"telephone_number": "702-550-6700",
"fax_number": "702-550-4872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3920 W ANN RD STE 100",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890313840",
"telephone_number": "702-550-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DONALD",
"middle_name": "RAY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-27",
"last_updated": "2018-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.