Individual provider Active NPI

Christi Maryjo Mannos, RDH

  • Specialist
  • Reno, NV
National Provider Identifier
1134734296
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
102015 Issued in NV
Practice address
10655 Professional Cir Ste a
Reno, NV 89521-5840
Phone
(775) 750-2173
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 102015 NV Primary

Addresses

Primary practice location

10655 Professional Cir Ste a
Reno, NV 89521-5840

Mailing address

10714 Vista Bonita LN
Reno, NV 89521-4128
Phone (775) 750-2173

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

State licenses

LicenseStateTypeSpecialty
102015NVMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1134734296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10714 VISTA BONITA LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895214128",
            "telephone_number": "775-750-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10655 PROFESSIONAL CIR STE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215840",
            "telephone_number": "775-750-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNOS",
        "first_name": "CHRISTI",
        "middle_name": "MARYJO",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "102015",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 14, 2020; 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.