Organization Active NPI

Merry Medical Team

  • Family Medicine Physician
  • Minden, NV
National Provider Identifier
1194791962
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERRY MEDICAL TEAM
Practice address
1649 Lucerne St
Ste a & B
Minden, NV 89423-4363
Phone
(775) 782-1603
Fax
(775) 782-3427
NPI assigned
Feb 23, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Thomas Gordon Merry, MDNPI 1689648719
Title
President
Phone
(775) 782-1603

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NV Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

1649 Lucerne St
Ste a & B
Minden, NV 89423-4363

Mailing address

1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 543-5659

Other identifiers 1

IdentifierTypeStateIssuer
100506316MedicaidNV

National Provider Directory

National Provider Directory

Locations

1077 4th St
Ste 2
South Lake Tahoe, CA 96150

1107 US Highway 395 N
Ste C
Gardnerville, NV 89410
Phone (775) 782-1603

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1194791962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506207",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 LUCERNE ST",
            "address_2": "STE A & B",
            "city": "MINDEN",
            "state": "NV",
            "postal_code": "894234363",
            "telephone_number": "775-782-1603",
            "fax_number": "775-782-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRY MEDICAL TEAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MERRY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "775-782-1603",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506316",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minden, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.