Emelita Demetillo Liwanag, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13024 Issued in NV

Practice address

1835 Oddie Blvd
Sparks, NV 89431-3559

Phone

(775) 982-5140

Fax

(775) 982-5141

NPI assigned

Apr 23, 2008

Last updated

Aug 31, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1275708182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 ODDIE BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894313559",
            "telephone_number": "775-982-5140",
            "fax_number": "775-982-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIWANAG",
        "first_name": "EMELITA",
        "middle_name": "DEMETILLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "L.2736R",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "13024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275708182",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11985918",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Linney
• Alecia Ann Lint
• Little Angel Care Home , LLC
• Cynthia A Littler, RN
• Tianli Liu
• Lloyd B. Austin DDS (Dentistry for Children Associates)
• Michael Lloyd, CADC-I
• Amy Renee Locke, ACNPC-AG
• Andrea Jill Loeschner, B S
• Boris Lokshin, M.D.

• Family Medicine Physician in Sparks, NV
• Providers in Sparks, 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, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.