Provider Demographics
NPI:1891895454
Name:YI, SCOTT (DPT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:YI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 W HORIZON RIDGE PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3997
Mailing Address - Country:US
Mailing Address - Phone:702-312-4878
Mailing Address - Fax:
Practice Address - Street 1:2790 W HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3997
Practice Address - Country:US
Practice Address - Phone:702-312-4878
Practice Address - Fax:702-312-4886
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1818225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100503744Medicaid
NVV36885Medicare PIN
NVV39906Medicare PIN