Pyramid Lake Paiute Tribe

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

PYRAMID LAKE PAIUTE TRIBE

Practice address

705 Highway 446
Nixon, NV 89424

Phone

(775) 574-1018

Fax

(775) 574-1114

NPI assigned

Aug 22, 2006

Organization subpart

No

Name

Mrs. Dawna Lee Brown

Title

Health Director

Phone

(775) 574-1018

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Pyramid Lake Paiute Tribe

  • Land Ambulance
  • Nixon, NV
  • NPI 1881007037

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pyramid Lake Paiute Tribe

  • Land Ambulance
  • Nixon, NV
  • NPI 1881007037

  5799746376

  Same PAC ID

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William M. Wakefield, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1629017165
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in TX

Legal name

PYRAMID LAKE PAIUTE TRIBE

Doing business as

PYRAMID LAKE TRIBAL HEALTH CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 27, 2009

Last certification

Mar 27, 2009

Ownership / control type

For profit – corporation

Organization structure

OtherNon-profit

Enrollment address

705 Highway 446
Pyramid Lake Tribal Health Clinic
Nixon, NV 89424-0227

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73661

• Pyramid Lake Tribal Health Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 1, 2016.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1285740035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 227",
            "city": "NIXON",
            "state": "NV",
            "postal_code": "89424",
            "telephone_number": "775-574-1018",
            "fax_number": "775-574-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 HIGHWAY 446",
            "city": "NIXON",
            "state": "NV",
            "postal_code": "89424",
            "telephone_number": "775-574-1018",
            "fax_number": "775-574-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PYRAMID LAKE PAIUTE TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2016-02-01",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DAWNA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "775-574-1018",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4716673",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pyramid Lake Tribal Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rosanne J Pang, LPN
• Donald Joseph Pelt, EMT
• Paul Richard Perkins, DR. (PHD)
• Pyramid Lake Health Center
• Pyramid Lake Indian Health Service Pharmacy
• Pyramid Lake Paiute Tribe
• Pyramid Lake Paiute Tribe
• Pyramid Lake Tribal Health Center
• Pyramid Lake Tribal Health Clinic
• Timothy Louis Ricks, D.M.D., M.P.H.

• All providers in Nixon, NV
• Federally Qualified Health Center (FQHC) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.