MEDICARE: STACY JO NEEDHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1874	NV

General Provider Information

NPI Number	:	1356093637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY JO NEEDHAM

Provider Business Mailing Address
First Line	:	2320 IONE RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7943
Country	:	US
Telephone Number	:	725-200-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2320 IONE RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7943
Country	:	US
Telephone Number	:	725-200-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2022
Last Update Date	:	01/19/2022

Similar Medicare Providers

1740998434 — MR. TED R VIDAL II PTA, LMT
Practice Location Address:

2350 IONE RD
LAS VEGAS, NV
89183-7943

Practice Phone: 702-790-3000
Practice Fax:

1215436456 — YORDANIS GAINZA DESPAIGNE
Practice Location Address:

4715 VEGAS VALLEY DR UNIT 17
LAS VEGAS, NV
89121-7943

Practice Phone: 832-803-7675
Practice Fax:

1700714581 — PARIS BROWN RN
Practice Location Address:

10238 QUAINT TREE ST
LAS VEGAS, NV
89183-4252

Practice Phone: 858-309-2922
Practice Fax:

1649251265 — DR. RICARDO Z VINUYA MD
Practice Location Address:

1655 E CACTUS AVE STE 210
LAS VEGAS, NV
89183-7723

Practice Phone: 702-724-8844
Practice Fax:

1700869054 — LAUREN V ABELA PA-C
Practice Location Address:

9975 S EASTERN AVE STE 110
LAS VEGAS, NV
89183-7950

Practice Phone: 702-492-7208
Practice Fax: 702-616-0657

1598735599 — BARRY YVES BORNSTEIN PA
Practice Location Address:

1655 E CACTUS AVE STE 120
LAS VEGAS, NV
89183-7723

Practice Phone: 702-737-1880
Practice Fax: 702-737-5988

Directions to “ STACY JO NEEDHAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.