SPORTS MEDICINE REHABILITATION (NPI# 1558397059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558397059 |
| Entity Type | Organization |
| Organization Name | SPORTS MEDICINE REHABILITATION |
| Other Organization Name | FAMILY WELLNESS CLINIC |
| Practice Address |
10001 S Eastern Ave 210 Henderson NV 89052-3907 |
| Practice Telephone | 7028374397 |
| Practice Fax Number | 7028377426 |
| Mailing Telephone | 7028374397 |
| Mailing Fax Number | 7028377426 |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | CASIANO R FLAVIANO (PRESIDENT) |
| Authorized Official Telephone | 7028374397 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 9976 | NV | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Family Wellness Clinic | Doing Business As Name - Organization |
| Street Address |
10001 S EASTERN AVE 210 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89052-3907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871596338 | Casiano R Flaviano IIi | Physical Medicine & Rehabilitation | 10001 S Eastern Ave, Ste 210, Henderson, NV 89052-3907 | 2005-05-27 |
| 1740727007 | Hannah Furney | Nurse Practitioner | 10001 S Eastern Ave, Suite #108, Henderson, NV 89052 | 2017-01-25 |
| 1972046720 | Edelyn Barry | Nurse Practitioner | 10001 S Eastern Ave, Suite 307, Henderson, NV 89052-3907 | 2016-11-28 |
| 1427449297 | Seyed Abbas Mirabbasi | Internal Medicine | 10001 S Eastern Ave, Henderson, NV 89052-3907 | 2015-02-13 |
| 1376805416 | Dignity Health Medical Group Nevada, LLC | Family Medicine | 10001 S Eastern Ave, Suite 209, Henderson, NV 89052-3907 | 2012-06-14 |
| 1437439544 | Kimberly Erin Difillippo | Physician Assistant | 10001 S Eastern Ave, Suite 310, Henderson, NV 89052-3907 | 2011-08-19 |
| 1285944769 | Darcie Ellen Emge | Physician Assistant | 10001 S Eastern Ave, Suite 310, Henderson, NV 89052-3907 | 2010-10-18 |
| 1134437114 | Scott Selco Professional Corporation | Psychiatry & Neurology | 10001 S Eastern Ave, Suite 409, Henderson, NV 89052-3907 | 2010-09-23 |
| 1770712036 | I Fix Yu, Ltd | Orthopaedic Surgery | 10001 S Eastern Ave, Suite 406, Henderson, NV 89052-3907 | 2009-07-08 |
| 1861648545 | Harpreet Kaur Tsui | Internal Medicine | 10001 S Eastern Ave, Suite 101, Henderson, NV 89052-3907 | 2008-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
| 1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| 1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
| 1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
| 1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
| Find all providers in zip 89052 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386018141 | Robert Gannon | Specialist | 1689 Sebring Hills Dr, Henderson, NV 89052-6930 | 2015-11-17 |
| 1992135149 | Jennifer Coon | Specialist | 158 Coyote Hills St, Henderson, NV 89012-6003 | 2013-11-24 |
| 1528325990 | Gary Stephen Marrone | Specialist | 5 Quail Hollow Dr, Henderson, NV 89014-2144 | 2012-04-23 |
| 1194094870 | Jeffrey Allyn Gahr | Specialist | 391 Marlin Cove Rd, Henderson, NV 89012-4830 | 2011-12-23 |
| 1639308943 | Robert David Lieberman | Specialist | 866 Seven Hills Dr Ste 201, Henderson, NV 89052 | 2009-07-08 |
| 1811139041 | Warren Hankins Md,pc. | Specialist | 9053 S Pecos Rd Ste 3000, Henderson, NV 89074-7179 | 2009-04-02 |
| 1114176427 | Healthy Connections By Joanie | Specialist | 2 Commerce Center Dr, Suite A-10, Henderson, NV 89014-2334 | 2008-09-10 |
| 1760679161 | Joseph P Klein | Specialist | 623 Pinetop Lake St, Henderson, NV 89002-0922 | 2007-09-28 |
| 1043419229 | Billy J Greenville | Specialist | 709 S Main St, Henderson, TX 75654-3946 | 2007-07-17 |
| 1619194768 | Nutan K Parikh Md Ltd Apc | Specialist | 2904 W. Horizon Ridge Pkwy, Suite 200, Henderson, NV 89052 | 2007-04-19 |
| Find all providers in HENDERSON | ||||
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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.