GOOD SHEPHERD REHAB INC. (NPI# 1386933315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386933315 |
| Entity Type | Organization |
| Organization Name | GOOD SHEPHERD REHAB INC. |
| Practice Address |
4275 Burnham Ave Ste 255 Las Vegas NV 89119-8204 |
| Practice Telephone | 7023801060 |
| Practice Fax Number | 7023801081 |
| Mailing Telephone | 7023801060 |
| Mailing Fax Number | 7023801081 |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2011-03-30 |
| Authorized Official Name | MR. RAUL ABEJUELA (CEO) |
| Authorized Official Telephone | 7028933333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
20071354581 | NV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 001702161 | 05 |
| Street Address |
4275 BURNHAM AVE STE 255 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89119-8204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568524692 | Karl John Samonte | Physical Therapist | 4275 Burnham Ave Ste 255, Las Vegas, NV 89119-8204 | 2006-12-14 |
| 1962935288 | Tiffany Bradley | Family Medicine | 4275 Burnham Ave Ste 255, Las Vegas, NV 89119-8204 | 2017-04-04 |
| 1972893196 | Evita Daradal Alegre | Registered Nurse | 4275 Burnham Ave Ste 255, Las Vegas, NV 89119-8204 | 2011-04-08 |
| 1255620035 | Betsy Omandac | Respiratory Therapist, Certified | 4275 Burnham Ave Ste 255, Las Vegas, NV 89119-8204 | 2011-04-01 |
| 1982993911 | Deborah Quarz | Respiratory Therapist, Certified | 4275 Burnham Ave Ste 255, Las Vegas, NV 89119-8204 | 2011-03-30 |
| 1215238845 | Duchess Menchavez | Occupational Therapist | 4275 Burnham Ave Ste 255, Las Vegas, NV 89119-8204 | 2010-11-12 |
| 1407156102 | Julieta Ramos | Registered Nurse | 4275 Burnham Ave Ste 255, Las Vegas, NV 89119-8204 | 2010-10-27 |
| 1437477726 | Sarah Kathleen Cervantes | Registered Nurse | 4275 Burnham Ave Ste 255, Las Vegas, NV 89119-8204 | 2010-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089298 | Jennifer Chavon Cruse | Technician | Safeathomecaregiver@gmail.com, 1775 East Tropicana Avenue 16-b, Las Vegas, NV 89119 | 2020-09-28 |
| 1063024214 | Rosa Isela Martinez Gonzalez | Technician | 4324 S. Eastern Ave. Ste. B, Las Vegas, NV 89119 | 2020-08-19 |
| 1720697980 | Christian Scott | Social Worker | 4055 Spencer St #118, Las Vegas, NV 89119 | 2020-07-23 |
| 1245867159 | Starfruit Holdings, LLC | Skilled Nursing Facility | 4375 S Eastern Ave, Paradise, NV 89119 | 2020-03-23 |
| 1215562376 | Phyllis Eberechukwu Hunt | Adult Companion | 5160 Tamarus St Appt 17, Las Vegas, NV 89119 | 2020-03-10 |
| 1841832581 | Legna Carrillo | Adult Companion | 4325 South Bruce St Appt 63, Las Vegas, NV 89119 | 2019-10-15 |
| 1104468339 | Alma Leticia Salazar | Home Health Aide | Safe At Home, LLC, 1775 E. Tropicana Ave. Suit 16-b, Las Vegas, NV 89119 | 2019-10-09 |
| 1083260046 | Araceli Rosas Vargas | Technician | 5160 S. Eastern Ave, Suite E, Las Vegas, NV 89119 | 2019-08-15 |
| 1376197707 | Bristure Clayton | Technician | Safe At Home LLC, 1775 E Tropicana Ave Ste 16, Las Vegas, NV 89119 | 2019-07-24 |
| 1457904534 | Carmen Laura Gonzalez Valenzuela | Chore Provider | 6725-1 S. Eastern Ave, Las Vegas, NV 89119 | 2019-07-18 |
| Find all providers in zip 89119 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526045 | Direct To You Physical Therapy, Pllc | Clinic/Center | 10334 Howling Coyote Ave, Las Vegas, NV 89135-1119 | 2020-07-27 |
| 1437778784 | Lvc Physical Therapy LLC | Clinic/Center | 1050 S Rainbow Blvd Ste 210, Las Vegas, NV 89145-6231 | 2020-04-15 |
| 1427695543 | Aaa Physical Therapy LLC | Clinic/Center | 633 N. Decatur Blvd., Suite E, Las Vegas, NV 89107 | 2019-12-09 |
| 1598316598 | Grow Therapy Nv | Clinic/Center | 9321 Colorful Rainbow Ave, Las Vegas, NV 89166-3777 | 2019-09-23 |
| 1558921205 | Onsight Movement, LLC | Clinic/Center | 10809 Garden Mist Dr Apt 2051, Las Vegas, NV 89135-2886 | 2019-06-15 |
| 1376018556 | Gemm Physical Therapy LLC | Clinic/Center | 9646 Kirkland Ranch Ct, Las Vegas, NV 89139-7496 | 2018-10-03 |
| 1285111823 | Pr Acquisition Corporation | Clinic/Center | 6048 S Durango Dr Ste 100&105, Las Vegas, NV 89113-1781 | 2018-07-26 |
| 1831604099 | Occupational Health Centers of The Southwest, P.a. | Clinic/Center | 3000 Las Vegas Blvd S Trlr C, Las Vegas, NV 89109-1932 | 2017-12-11 |
| 1982947701 | A-grav 1 LLC | Clinic/Center | 365 E Windmill Ln, Las Vegas, NV 89123-1807 | 2013-03-29 |
| 1972775542 | Arc Therapy Services LLC | Clinic/Center | 6650 W Flamingo Rd, Las Vegas, NV 89103-2142 | 2008-03-24 |
| Find all providers in LAS VEGAS | ||||
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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.