Active NPI
Andrea Lavon Hyde
- Physical Therapist
- Reno, NV
National Provider Identifier
1255062303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0907
- Practice address
- 10587 Double R Blvd Ste 101
Reno, NV 89521-8966 - Phone
- (775) 324-5371
- Fax
- (775) 852-5373
- NPI assigned
- Jun 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0907 | NV | Primary |
Addresses
Primary practice location
10587 Double R Blvd Ste 101
Reno, NV 89521-8966
Mailing address
14760 Granite Mine Dr
Reno, NV 89521-8320
Phone (775) 742-3102
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0907 | NV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655683200000",
"number": "1255062303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14760 GRANITE MINE DR",
"city": "RENO",
"state": "NV",
"postal_code": "895218320",
"telephone_number": "775-742-3102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10587 DOUBLE R BLVD STE 101",
"city": "RENO",
"state": "NV",
"postal_code": "895218966",
"telephone_number": "775-324-5371",
"fax_number": "775-852-5373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HYDE",
"first_name": "ANDREA",
"middle_name": "LAVON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-20",
"last_updated": "2022-06-20",
"certification_date": "2022-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "0907",
"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 Jun 20, 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.