MR. ROGER E.T. WILLIS (NPI# 1639473531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639473531 |
| Entity Type | Individual |
| Full Name | MR. ROGER E.T. WILLIS |
| Practice Address |
2821 White Peaks Ave N Las Vegas NV 89081-2437 |
| Practice Telephone | 9016536410 |
| Mailing Telephone | 9016536410 |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2011-01-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477501815 | Roger Cecil Willis | Family Medicine | 600 Miluk Drive, Coos Bay, OR 97420 | 2006-05-05 |
| 1770056491 | Roger F Willis IIi | Counselor | 4343 Williamsbourgh Dr, Sacramento, CA 95823-2006 | 2019-01-04 |
| 1386683423 | Roger Willis | Emergency Medicine | 8026 Floyd Curl, San Antonio, TX 78229-3915 | 2006-06-05 |
| Street Address |
2821 WHITE PEAKS AVE |
| City | N LAS VEGAS |
| State | NV |
| Zip Code | 89081-2437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013211911 | Crystal Ann Willis | Rehabilitation Practitioner | 2821 White Peaks Ave, N Las Vegas, NV 89081-2437 | 2011-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144879719 | Saniya Dion Wilson | Technician | 4828 Celsion Rock Street, Las Vegas, NV 89081 | 2019-09-06 |
| 1932609526 | Victoria Lashelle Jones | Chore Provider | 3821 Pecos Park Ave, Las Vegas, NV 89081 | 2018-02-20 |
| 1912414483 | Ar Complete Homecare, Inc | Chore Provider | 1127 Emerald Stone Ave, N Las Vegas, NV 89081 | 2018-01-05 |
| 1558872986 | Noemi Cabrera | Nurse Practitioner | 6121 Broccoli St, N. Las Vegas, NV 89081 | 2017-10-12 |
| 1912426909 | Olive Branch Mentoring | Community/Behavioral Health | 5548 Ayers Cliff Street, North Las Vegas, NV 89081 | 2017-09-12 |
| 1336689447 | Andrew Rooks | Student in an Organized Health Care Education/Training Program | 5005 Losee Road, 2016, North Las Vegas, NV 89081 | 2017-03-08 |
| 1932649464 | Sheila Flipse | Counselor | 713 Mission Del Oro Avenue, North Las Vegas, NV 89081 | 2017-03-02 |
| 1376090894 | Rebuilding To Success | Community/Behavioral Health | 3212 Carolina Moon Ave, North Las Vegas, NV 89081 | 2016-09-01 |
| 1447602164 | Courage-cynthia Ugbodu | Counselor | 5424 Talmo St, North Las Vegas, NV 89081 | 2016-07-06 |
| 1710338686 | Dejuan Peterson | Social Worker | 2825 Aspen Club Ave, North Las Vegas, NV 89081 | 2016-06-22 |
| Find all providers in zip 89081 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780223321 | Kushica K Flowers | Rehabilitation Practitioner | 5005 Losee Rd Apt 1108, N Las Vegas, NV 89081-2495 | 2019-12-30 |
| 1619466760 | Kyjana Small | Rehabilitation Practitioner | 5816 Creekside Sands Ln, N Las Vegas, NV 89031-3645 | 2018-05-03 |
| 1558737015 | Nina Davis | Rehabilitation Practitioner | 6023 Glitter Gold Ct, N Las Vegas, NV 89031-7212 | 2015-08-18 |
| 1205218674 | Markesha Nix-powell | Rehabilitation Practitioner | 2444 Englestad St, N Las Vegas, NV 89030-3816 | 2015-06-22 |
| 1992184725 | Christine Briley | Rehabilitation Practitioner | 5239 English Aster Ct, N Las Vegas, NV 89081-4004 | 2015-05-26 |
| 1972906451 | Genevieve Batiste | Rehabilitation Practitioner | 4538 W Craig Rd Ste 250, N Las Vegas, NV 89032-2510 | 2014-09-29 |
| 1184047979 | Beverly Magot Harrison | Rehabilitation Practitioner | 416 W Azure Ave, N Las Vegas, NV 89031-1368 | 2014-01-29 |
| 1770904104 | Mayra Ornelas | Rehabilitation Practitioner | 3145 Manti Peak Ave, N Las Vegas, NV 89081-6550 | 2014-01-03 |
| 1588090666 | Sara Johnson | Rehabilitation Practitioner | 1627 Bent Arrow Dr, N Las Vegas, NV 89031-1559 | 2013-09-19 |
| 1609215524 | Charlette Smith | Rehabilitation Practitioner | 2724 Advancement Ave, N Las Vegas, NV 89031-0953 | 2013-06-25 |
| Find all providers in N LAS VEGAS | ||||
| City | N LAS VEGAS |
| Zip Code | 89081 |
Please comment or provide details below to improve the information on MR. ROGER E.T. WILLIS.
| 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.