A.M. Waldron MD, LTD.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

NV10149 Issued in NV

Legal business name

A.M. WALDRON MD, LTD.

Practice address

5595 Kietzke LN
Ste. 112
Reno, NV 89511-3029

Phone

(775) 636-7313

Fax

(775) 657-6129

NPI assigned

Feb 21, 2014

Last updated

Feb 21, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rick Stockton

Title

Office Manager

Phone

(775) 636-7313

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1194140582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5595 KIETZKE LN",
            "address_2": "STE. 112",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113029",
            "telephone_number": "775-636-7313",
            "fax_number": "775-657-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5595 KIETZKE LN",
            "address_2": "STE. 112",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113029",
            "telephone_number": "775-636-7313",
            "fax_number": "775-657-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.M. WALDRON MD, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-21",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "STOCKTON",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "775-636-7313"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "NV10149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477612240",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.