MMK LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MMK LLC

Doing business as

Kathleen A Stoll, MD

Practice address

540 W Plumb LN Ste 120
Reno, NV 89509-3691

Phone

(775) 432-2200

Fax

(775) 432-2992

NPI assigned

Dec 21, 2022

Last updated

Dec 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Hawanya B Miller

Title

Credentialing Specialist

Phone

(984) 464-0774

Specialties & licenses 1

Addresses

Other names 1

• Kathleen A Stoll, MD Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

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.

• Kathleen A Stoll, MD

  • Psychiatry Physician
  • Reno, NV
  • NPI 1588779938
  Medicare reassignment NPD

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1346952322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W PLUMB LN STE B-157",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093468",
            "telephone_number": "775-432-2200",
            "fax_number": "775-432-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W PLUMB LN STE 120",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093691",
            "telephone_number": "775-432-2200",
            "fax_number": "775-432-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "HAWANYA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "984-464-0774",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kathleen A Stoll, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sayde Lynn Miura, FA
• Matt Eli Mixon
• Dean K. Miyagawa, MD
• William Toru Miyazaki, D.O.
• Anna Mkrtchyan
• Elena Mnatsakanyan
• Madisyn Moak
• Cyrus Demetrios Moassessi, OMD
• Sarah Rose Moats
• Lailoma Mobaligh

• Psychiatry Physician in Reno, NV
• Providers in Reno, NV by specialty
• Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.