Mountain Valley Physician Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOUNTAIN VALLEY PHYSICIAN GROUP, LLC

Doing business as

Mountain Valley Physician Group

Practice address

360 S Lola LN
Pahrump, NV 89048-0884

Phone

(775) 751-7580

Fax

(775) 751-7820

NPI assigned

Oct 9, 2007

Organization subpart

No

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

Authorized official

Name

Mark Stoddard

Title

Manager

Phone

(775) 751-7519

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Mountain Valley Physician Group Doing business as

Locations

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1235327909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S LOLA LN",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890480884",
            "telephone_number": "775-751-7580",
            "fax_number": "775-751-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S LOLA LN",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890480884",
            "telephone_number": "775-751-7580",
            "fax_number": "775-751-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VALLEY PHYSICIAN GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "STODDARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "775-751-7519"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235327909",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Valley Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marissa Morales
• Juanita Moreno
• Gayle Morgan, MSW
• Kevin Michael Morrison
• Jazmine Morrow
• Ryan John Muccio
• Shauna J Mullenix, PT
• Maria Elena Munoz Hernandez
• Brent Murphy
• Theresa Murray

• Family Medicine Physician in Pahrump, NV
• Providers in Pahrump, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.