MEDICARE: TMG KIDS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	103TB0200X	Cognitive & Behavioral Psychologist
3	133VN1004X	Pediatric Nutrition Registered Dietitian
4	207SG0201X	Clinical Genetics (M.D.) Physician
5	2080P0006X	Developmental - Behavioral Pediatrics Physician
6	224Z00000X	Occupational Therapy Assistant
7	224ZF0002X	Feeding, Eating & Swallowing Occupational Therapy Assistant
8	225100000X	Physical Therapist
9	2251P0200X	Pediatric Physical Therapist
10	225X00000X	Occupational Therapist
11	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist
12	225XP0200X	Pediatric Occupational Therapist
13	235Z00000X	Speech-Language Pathologist
14	261QM1300X	Multi-Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992138978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TMG KIDS LLC

Provider Business Mailing Address
First Line	:	6600 W CHARLESTON BLVD
Second Line	:	SUITE 111
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-9001
Country	:	US
Telephone Number	:	702-595-5437
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 W CHARLESTON BLVD
Second Line	:	SUITE 111
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-9001
Country	:	US
Telephone Number	:	702-595-5437
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	PATRICK SANTORO
Credential	:	OT
Telephone Number	:	702-595-5437

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	08/14/2013

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Directions to “TMG KIDS LLC ” Practice Location

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