NPIMap

Organization Active NPI

Nevada Health Centers Inc

Doing business as Crescent Valley Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Crescent Valley, NV
National Provider Identifier
1023196292
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEVADA HEALTH CENTERS INC
Doing business as
Crescent Valley Medical Clinic
Practice address
5043 Tenabo Avenue
Crescent Valley, NV 89821-1155
Phone
(775) 468-1010
Fax
(775) 468-1019
NPI assigned
Nov 2, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NEVADA HEALTH CENTERS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Walter B Davis
Title
Ceo
Phone
(775) 888-6610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NV Primary

Addresses

Primary practice location

5043 Tenabo Avenue
Crescent Valley, NV 89821-1155

Mailing address

3325 Research Way
Carson City, NV 89706-7913
Phone (775) 888-6610

Other identifiers 2

IdentifierTypeStateIssuer
DQ468DOtherNVMEDICARE ID - TYPE UNSPECIFIED
1023196292MedicaidNV

Other names 1

  • Crescent Valley Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000452 NV Part B Supplier - Clinic/Group Practice 7113835307 Receives reassigned benefits from 65 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV; North Las Vegas, NV; Pahrump, NV; Reno, NV; Virginia City, NV; West Wendover, NV; Amargosa Valley, NV; Austin, NV…

Other NPIs on the same Medicare enrollment 34

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 34

National Provider Directory

National Provider Directory
Part of
Fernley Family Medical

Locations

5043 Tenabo Ave
Crescent Valley, NV 89821
Phone (775) 468-0250

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023196292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 RESEARCH WAY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897067913",
            "telephone_number": "775-888-6610",
            "fax_number": "775-888-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5043 TENABO AVENUE",
            "city": "CRESCENT VALLEY",
            "state": "NV",
            "postal_code": "898211155",
            "telephone_number": "775-468-1010",
            "fax_number": "775-468-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA HEALTH CENTERS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEVADA HEALTH CENTERS INC",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "775-888-6610"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "DQ468D",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023196292",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crescent Valley Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crescent Valley, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.