NPIMap

Organization Active NPI

Washoe Tribe of Nevada and California

  • General Practice Physician
  • Gardnerville, NV
National Provider Identifier
1043608243
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WASHOE TRIBE OF NEVADA AND CALIFORNIA
Practice address
1559 Watasheamu
Gardnerville, NV 89460-7455
Phone
(775) 265-4215
Fax
(775) 265-6071
NPI assigned
Dec 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Mrs. Roseann Kizer
Title
Credentialing Coordinator
Phone
(775) 265-4215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1559 Watasheamu
Gardnerville, NV 89460-7455

Mailing address

1559 Watasheamu
Gardnerville, NV 89460-7455
Phone (775) 265-4215

Other names 1

  • WASHOE TRIBAL HEALTH CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Washoe Tribe of NV and Ca3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1559 Watasheamu Rd
Gardnerville, NV 89460
Phone (775) 265-4215

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1043608243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1559 WATASHEAMU",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894607455",
            "telephone_number": "775-265-4215",
            "fax_number": "775-265-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 WATASHEAMU",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894607455",
            "telephone_number": "775-265-4215",
            "fax_number": "775-265-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHOE TRIBE OF NEVADA AND CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "KIZER",
        "authorized_official_first_name": "ROSEANN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "775-265-4215",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WASHOE TRIBAL HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardnerville, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.