Individual provider Active NPI

Mark Funkhouser, PRSS;CHW

  • Peer Specialist
  • Reno, NV
National Provider Identifier
1295612133
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
PRSS-5038 Issued in NV
Practice address
2029 Cradle Mountain Dr Unit 2
Reno, NV 89523-2194
Phone
(812) 449-4343
NPI assigned
Aug 20, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X PRSS-5038 NV Primary

Addresses

Primary practice location

2029 Cradle Mountain Dr Unit 2
Reno, NV 89523-2194

Mailing address

2029 Cradle Mountain Dr Unit 2
Reno, NV 89523-2194
Phone (812) 449-4343

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

LicenseStateTypeSpecialty
PRSS-5038NVMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1295612133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 CRADLE MOUNTAIN DR UNIT 2",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895232194",
            "telephone_number": "812-449-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 CRADLE MOUNTAIN DR UNIT 2",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895232194",
            "telephone_number": "812-449-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNKHOUSER",
        "first_name": "MARK",
        "credential": "PRSS;CHW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NV",
            "license": "PRSS-5038",
            "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 Aug 20, 2025; 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.