Maple Star

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

MAPLE STAR

Practice address

4773 Caughlin Pkwy
Suite 2
Reno, NV 89519-1011

Phone

(775) 297-4208

NPI assigned

Jul 10, 2013

Organization subpart

No

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

Authorized official

Name

Deidra Elyce Mars

Title

Skills Rehabilitation Worker

Phone

(775) 287-4208

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1275974958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4773 CAUGHLIN PKWY",
            "address_2": "SUITE 2",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895191011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4773 CAUGHLIN PKWY",
            "address_2": "SUITE 2",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895191011",
            "telephone_number": "775-297-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE STAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "MARS",
        "authorized_official_first_name": "DEIDRA",
        "authorized_official_middle_name": "ELYCE",
        "authorized_official_title_or_position": "SKILLS REHABILITATION WORKER",
        "authorized_official_telephone_number": "775-287-4208"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880321776",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Manuel
• Samantha Eugene De Guzman Manuntag, MD
• Manzanita Family Therapy LLC
• Alayna Annie Manzano-Lopez
• Hadit M Manzo-Veliz
• Maple Star Nevada
• Maple Star Nevada
• Maple Star Nevada
• Maple Star Nevada
• Maple Star Nevada

• Community Health Worker in Reno, NV
• Providers in Reno, NV by specialty
• Community Health Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.