Individual provider Active NPI

David N Landis, MD

  • Diagnostic Radiology Physician
  • Carson City, NV
National Provider Identifier
1366474728
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4833 Issued in NV
Practice address
2874 N Carson St Ste 300
Carson City, NV 89706-1683
Phone
(775) 445-5500
Fax
(775) 852-6902
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G51035 CA
Diagnostic Radiology Physician 2085R0202X 4833 NV Primary

Addresses

Primary practice location

2874 N Carson St Ste 300
Carson City, NV 89706-1683

Mailing address

PO Box 2087
Carson City, NV 89702-2087
Phone (775) 882-0430

Other identifiers 4

IdentifierTypeStateIssuer
300042840OtherNVRAILROAD MEDICARE
002013011MedicaidNV
AX217XOtherCAMEDICARE PTAN
FS4913489OtherCAMEDICAL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51035CAMDPharmacist
G51035CAMDDiagnostic Radiology Physician
4833NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Valley Radiology, PLC PastSince Jan 1, 2012 Accepting new patients
Imaging Advanced Consultants LLC Past Accepting new patients
Arizona Advanced Imaging Center LLC Past Accepting new patients
Great Basin Imaging Diagnostic Radiology PastSince Oct 8, 2007 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1366474728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2087",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897022087",
            "telephone_number": "775-882-0430",
            "fax_number": "775-852-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2874 N CARSON ST STE 300",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897061683",
            "telephone_number": "775-445-5500",
            "fax_number": "775-852-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "DAVID",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G51035",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "4833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300042840",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002013011",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AX217X",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "FS4913489",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.