Ft. McDermitt Paiute-Shoshone Tribe

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

FT. MCDERMITT PAIUTE-SHOSHONE TRIBE

Doing business as

Ft. McDermitt Wellness Center

Practice address

112 North Reservation Rd
McDermitt, NV 89421-0315

Phone

(775) 532-8522

Fax

(775) 532-8024

NPI assigned

Mar 6, 2018

Last updated

Feb 20, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

FORT MCDERMITT WELLNESS CENTERAs reported in NPPES

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

Authorized official

Name

Mr. Fergus John LaughridgeNPI 1053761692

Title

Health Director

Phone

(775) 741-4328

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ft. McDermitt Wellness Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Fort McDermitt Wellness Center

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pamela Vanessa Johnson, ARNP

  • Nurse Practitioner
  • Deerfield Beach, FL
  • NPI 1770564189

  NV

  Medicare reassignment NPD
• Fergus John Laughridge Sr., AEMT

  • Intermediate Emergency Medical Technician
  • Winnemucca, NV
  • NPI 1053761692
  NPD Authorized official
• Alejandro Esquibel, MFTI

  • Mental Health Counselor
  • Reno, NV
  • NPI 1043667306
  NPD
• Jacqueline J. Bae, MD

  • Nutrition Education Nutritionist
  • Lakeport, CA
  • NPI 1245521749
  NPD

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771545600000",
    "number": "1316449291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 315",
            "city": "MC DERMITT",
            "state": "NV",
            "postal_code": "894210315",
            "telephone_number": "775-532-8522",
            "fax_number": "775-532-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 NORTH RESERVATION RD",
            "city": "MCDERMITT",
            "state": "NV",
            "postal_code": "894210315",
            "telephone_number": "775-532-8522",
            "fax_number": "775-532-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FT. MCDERMITT PAIUTE-SHOSHONE TRIBE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORT MCDERMITT WELLNESS CENTER",
        "enumeration_date": "2018-03-06",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A",
        "authorized_official_last_name": "LAUGHRIDGE",
        "authorized_official_first_name": "FERGUS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "775-741-4328",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100561450",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588710719",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@fmcdwc.org",
            "affiliation": "N",
            "address_1": "112 North Reservation Road",
            "city": "McDermitt",
            "state": "NV",
            "country_code": "US",
            "postal_code": "894210315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ft. McDermitt Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fort McDermitt Tribe (Fort McDermitt Wellness Center)
• Fort McDermitt Tribe (Fort McDermitt Wellness Center)
• Fort McDermitt Tribe (Fort McDermitt Wellness Center)
• Fort McDermitt Tribe (Fort McDermitt Wellness Center)
• Fort McDermitt Wellness Center
• Michael Dion Garfield, EMT-I
• Brandon Joseph Grow, EMT PARAMEDIC
• Tracy Marshall
• Stacy Irene Rust, RN
• Beverly Ann Shell, LPN-NURSE

• Federally Qualified Health Center (FQHC) in McDermitt, NV
• Providers in McDermitt, NV by specialty
• 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 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.