Individual provider Active NPI

Paul C Ludlow, MD

  • Facial Plastic Surgery Physician
  • Reno, NV
National Provider Identifier
1043216500
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
3496 Issued in NV
Practice address
75 Pringle Way Ste 509
Reno, NV 89502-1469
Phone
(775) 324-3800
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 3496 NV Primary

Addresses

Primary practice location

75 Pringle Way Ste 509
Reno, NV 89502-1469

Mailing address

59 Damonte Ranch Pkwy # B557
Reno, NV 89521-1907
Phone (775) 324-3800

Other identifiers 1

IdentifierTypeStateIssuer
002016138MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3496NVMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Lyon Health Center, Inc. Past Accepting new patients
Elko ENT Specialists PastSince Dec 1, 2006 Accepting new patients
Mt Grant General Hospital Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Bud a. West, M. D., LTD. Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1043216500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 DAMONTE RANCH PKWY # B557",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895211907",
            "telephone_number": "775-324-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY STE 509",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021469",
            "telephone_number": "775-324-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDLOW",
        "first_name": "PAUL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NV",
            "license": "3496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002016138",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.