MD DEVELOPMENTAL AGENCY (NPI# 1174140800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174140800 |
| Entity Type | Organization |
| Organization Name | MD DEVELOPMENTAL AGENCY |
| Practice Address |
2520 Saint Rose Pkwy Ste G220 Henderson NV 89074-7783 |
| Practice Telephone | 7734077558 |
| Practice Fax Number | 7028520430 |
| Mailing Telephone | 7734077558 |
| Mailing Fax Number | 7028520430 |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | DEBRA STEWART (CO-OWNER) |
| Authorized Official Telephone | 7734077558 |
| Authorized Official Credential | THERAPIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| MD Developmental AgencY | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2520 Saint Rose Pkwy Ste G220, Henderson, NV 890747783 | 7734077558 | 7028520430 |
| Street Address |
2520 SAINT ROSE PKWY STE G220 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89074-7783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349381 | Samuel Taylor Mulford | Physical Therapist | 9070 W.cheyenne Ave, Suite 100, Henderson, NV 89074 | 2020-06-03 |
| 1407369127 | Brenda Thomas | Dental Hygienist | 234 Polar Morning Place, Henderson, NV 89074 | 2017-11-16 |
| 1174036479 | Gail E Evans Wade | Behavioral Analyst | 1445 Stone Lake Cove, Henderson, NV 89074 | 2017-11-08 |
| 1710400957 | Kimberley Houk | Behavioral Analyst | 20 Avenida Picasso, Henderson, NV 89074 | 2017-07-19 |
| 1760911846 | Colin Ono-moore | Physical Therapist | 3 Rising Sun Ct, Henderson, NV 89074 | 2017-06-12 |
| 1851825764 | Ralph Wieder | Dietitian, Registered | 1005 Wigwam Pkwy, 23206, Henderson, NV 89074 | 2017-04-18 |
| 1811421712 | Henderson Long Term Care LLC | Skilled Nursing Facility | 2965 Wigwam Parkway, Henderson, NV 89074 | 2017-04-18 |
| 1275994642 | Malyna Lavarias | Behavioral Analyst | 74 N Pecos Rd., Suite C, Henderson, NV 89074 | 2016-03-14 |
| 1144608290 | Matthew Roderick | Acupuncturist | 2675 Windmill Pkwy Apt 421, Henderson, NV 89074 | 2015-05-08 |
| 1922494764 | Jennifer Romo Santistevan | Pediatrics | 1505 Wigwam Pkwy Ste 230, Henderson, NV 89074 | 2015-04-08 |
| Find all providers in zip 89074 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881233682 | Michelle Ford | Developmental Therapist | 308 Romeo Ct, Henderson, NC 27537-4809 | 2019-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245653179 | Sharolyn Renee Douglass | Developmental Therapist | 5890 Autumn Harvest Ave, Ave, Las Vegas, NV 89142-0805 | 2014-01-29 |
| 1720639362 | Jodie Sipes | Developmental Therapist | 7281 W Charleston Blvd, Las Vegas, NV 89117-1592 | 2019-09-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.