Active NPI
Elizabeth Dodge, PHARMD
- Pharmacist
- Reno, NV
National Provider Identifier
1063835023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16765
- Practice address
- 4835 Kietzke LN
Reno, NV 89509-6549 - Phone
- (775) 829-7922
- Fax
- (775) 829-8202
- NPI assigned
- Jan 28, 2014
- Last updated
- Jan 28, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16765 | NV | Primary |
Addresses
Primary practice location
4835 Kietzke LN
Reno, NV 89509-6549
Mailing address
4835 Kietzke LN
Reno, NV 89509-6549
Phone (775) 829-7922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16765 | Other | NV | PHARMACIST OF NEVADA LICENSE NUMBER |
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16765 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390867200000",
"number": "1063835023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4835 KIETZKE LN",
"city": "RENO",
"state": "NV",
"postal_code": "895096549",
"telephone_number": "775-829-7922",
"fax_number": "775-829-8202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4835 KIETZKE LN",
"city": "RENO",
"state": "NV",
"postal_code": "895096549",
"telephone_number": "775-829-7922",
"fax_number": "775-829-8202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODGE",
"first_name": "ELIZABETH",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-28",
"last_updated": "2014-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "16765",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST OF NEVADA LICENSE NUMBER",
"identifier": "16765",
"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 Jan 28, 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.