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Organization Active NPI

State of NV Aging & Disability Sevices Division- Fe Waiver

  • PACE Provider Organization
  • Carson City, NV
National Provider Identifier
1093289928
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
STATE OF NV AGING & DISABILITY SEVICES DIVISION- FE WAIVER
Practice address
3416 Goni Rd BLDG D
Carson City, NV 89706-8008
Phone
(775) 687-2487
NPI assigned
Jan 14, 2019
Last updated
Dec 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Authorized official

Name
Anil Manocha
Title
Administrative Services Officer
Phone
(775) 687-2487

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X NU Primary

Addresses

Primary practice location

3416 Goni Rd BLDG D
Carson City, NV 89706-8008

Mailing address

3416 Goni Rd BLDG D
Carson City, NV 89706-8008
Phone (775) 687-2487

National Provider Directory

National Provider Directory
Tax ID family
State of Nevada Bureau125 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1093289928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 GONI RD BLDG D",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897068008",
            "telephone_number": "775-687-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 GONI RD BLDG D",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897068008",
            "telephone_number": "775-687-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NV AGING & DISABILITY SEVICES DIVISION- FE WAIVER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "MANOCHA",
        "authorized_official_first_name": "ANIL",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES OFFICER",
        "authorized_official_telephone_number": "775-687-2487"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.