MEDICARE: GOOD SHEPHERD HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	2251C2600X	Cardiopulmonary Physical Therapist	NV
2	2251G0304X	Geriatric Physical Therapist	NV
3	2251N0400X	Neurology Physical Therapist	NV
4	2251X0800X	Orthopedic Physical Therapist	NV
5	225200000X	Physical Therapy Assistant	NV
6	225B00000X	Pulmonary Function Technologist	NV
7	225X00000X	Occupational Therapist	NV
8	2278P1005X	Pulmonary Rehabilitation Certified Respiratory Therapist	NV
9	2279P1005X	Pulmonary Rehabilitation Registered Respiratory Therapist	NV
10	1041C0700X	Clinical Social Worker	NV
11	133NN1002X	Nutrition Education Nutritionist	NV
12	163WC3500X	Cardiac Rehabilitation Registered Nurse	NV
13	224Z00000X	Occupational Therapy Assistant	NV
14	225100000X	Physical Therapist	NV
15	235Z00000X	Speech-Language Pathologist	NV

General Provider Information

NPI Number	:	1841365723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD SHEPHERD HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	2451 SOUTH BUFFALO DRIVE SUITE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2749
Country	:	US
Telephone Number	:	702-380-1060
Fax Number	:	702-380-1081

Provider Business Practice Location Address
First Line	:	2451 SOUTH BUFFALO DRIVE SUITE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2749
Country	:	US
Telephone Number	:	702-380-1060
Fax Number	:	702-380-1081

Authorized Official
Title or Position	:	CEO
Name	:	BENIGNO MANAHAN TUAZON
Credential	:
Telephone Number	:	702-380-1060

Provider Enumeration Date	:	11/23/2006
Last Update Date	:	09/11/2025

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