Wells Ave Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WELLS AVE CLINIC

Practice address

1255 S Wells Ave
Reno, NV 89502-2504

Phone

(775) 284-5004

Fax

(775) 313-0894

NPI assigned

Mar 12, 2015

Organization subpart

No

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

Authorized official

Name

Vidur Siddhanth Mahadeva, M.D.

Title

Sole Owner

Phone

(775) 247-2917

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1215320304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 S WELLS AVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022504",
            "telephone_number": "775-284-5004",
            "fax_number": "775-313-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 S WELLS AVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022504",
            "telephone_number": "775-284-5004",
            "fax_number": "775-313-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLS AVE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "MAHADEVA",
        "authorized_official_first_name": "VIDUR",
        "authorized_official_middle_name": "SIDDHANTH",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "775-247-2917",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary F Wellhoner, M.D.
• Kathryn Lee Wellington-Cavakis
• Erica Wellington, MS
• Jana Marie Wellman, MFT
• Cassie Ann Wellock, PA-C
• Eileen Wells
• Elizabeth Chaya Wells, OTR/L
• Izabella Wells, D.M.D.
• Jazzlyn Marie Wells
• Justine Wells

• Internal Medicine Physician in Reno, NV
• Providers in Reno, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.