Active NPI
Phillip Joseph Mareno Jr., CTRS
- Recreation Therapist
- Reno, NV
National Provider Identifier
1306564935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 32110
- Practice address
- 690 Edison Way
Reno, NV 89502-4135 - Phone
- (775) 772-3788
- NPI assigned
- Aug 19, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 32110 | NV | Primary |
Addresses
Primary practice location
690 Edison Way
Reno, NV 89502-4135
Mailing address
690 Edison Way
Reno, NV 89502-4135
Phone (775) 858-3303
Other practice location 1
650 Edison Way
Reno, NV 89502-4100
Phone (775) 772-3788
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 |
|---|---|---|---|
| 32110 | NV | MD | Recreation Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Springs LLC | Past | Accepting new patients | |
| Willow Springs, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Residential Treatment Facility
- Reno, NV
- NPI 1790883205
-
- Mental Illness Community Based Residential Treatment Facility
- Sparks, NV
- NPI 1841311784
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660867200000",
"number": "1306564935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 EDISON WAY",
"city": "RENO",
"state": "NV",
"postal_code": "895024135",
"telephone_number": "775-858-3303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 EDISON WAY",
"city": "RENO",
"state": "NV",
"postal_code": "895024135",
"telephone_number": "775-772-3788"
}
],
"practiceLocations": [
{
"address_1": "650 Edison Way",
"address_purpose": "LOCATION",
"city": "Reno",
"state": "NV",
"postal_code": "895024100",
"country_code": "US",
"telephone_number": "775-772-3788",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARENO",
"first_name": "PHILLIP",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-19",
"last_updated": "2022-08-19",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "NV",
"license": "32110",
"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 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.