Active NPI
Russell Guisti, O.D.
- Optometrist
- Fallon, NV
National Provider Identifier
1295878395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 123
- Practice address
- 2333 Reno Hwy
Fallon, NV 89406-6385 - Phone
- (775) 428-6664
- Fax
- (775) 428-6664
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 123 | NV | Primary |
Addresses
Primary practice location
2333 Reno Hwy
Fallon, NV 89406-6385
Mailing address
2333 Reno Hwy
Fallon, NV 89406-6385
Phone (775) 428-6664
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295878395 | Medicaid | NV |
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 |
|---|---|---|---|
| 123 | NV | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237248000000",
"number": "1295878395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2333 RENO HWY",
"city": "FALLON",
"state": "NV",
"postal_code": "894066385",
"telephone_number": "775-428-6664",
"fax_number": "775-428-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2333 RENO HWY",
"city": "FALLON",
"state": "NV",
"postal_code": "894066385",
"telephone_number": "775-428-6664",
"fax_number": "775-428-6664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUISTI",
"first_name": "RUSSELL",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2009-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NV",
"license": "123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1295878395",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fallon, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.