Individual provider Active NPI

Gwenyth G Obryan, PHD

  • Clinical Psychologist
  • Reno, NV
National Provider Identifier
1326065814
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY048 Issued in NV
Practice address
325 Flint St
Reno, NV 89501
Phone
(775) 329-3339
Fax
(775) 329-9935
NPI assigned
Jul 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY048 NV Primary

Addresses

Primary practice location

325 Flint St
Reno, NV 89501

Mailing address

325 Flint St
Reno, NV 89501
Phone (775) 329-3339

Other identifiers 1

IdentifierTypeStateIssuer
36124OtherNVMEDICARE CORPORATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120423000230 NV Practitioner - Clinical Psychologist 0749441590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

325 Flint St
Reno, NV 89501-2005
Phone (775) 329-3339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY048NVMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gwen Obryan PHD LTD Clinical CurrentSince Sep 1, 2012 Accepting new patients
Traci B Pitts PHD Inc Clinical Past Accepting new patients

Locations

325 Flint St
Reno, NV 89501
Phone (775) 329-3339

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326065814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 FLINT ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89501",
            "telephone_number": "775-329-3339",
            "fax_number": "775-329-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 FLINT ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89501",
            "telephone_number": "775-329-3339",
            "fax_number": "775-329-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRYAN",
        "first_name": "GWENYTH",
        "middle_name": "G",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CORPORATION",
            "identifier": "36124",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.