Active NPI
Shayne Davis
- Community/Behavioral Health Agency
- Reno, NV
National Provider Identifier
1376054288
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 19, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Practice address
- 7168 Crest Hill Dr
Reno, NV 89506-5634 - Phone
- (775) 360-6294
- NPI assigned
- Oct 18, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
7168 Crest Hill Dr
Reno, NV 89506-5634
Mailing address
3258 Bunker Hill LN
Sparks, NV 89431-1150
Phone (775) 379-0954
Other practice location 1
3258 Bunker Hill Ln
Sparks, NV 89431-1150
Phone (775) 379-0954
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1376054288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3258 BUNKER HILL LN",
"city": "SPARKS",
"state": "NV",
"postal_code": "894311150",
"telephone_number": "775-379-0954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7168 CREST HILL DR",
"city": "RENO",
"state": "NV",
"postal_code": "895065634",
"telephone_number": "775-360-6294"
}
],
"practiceLocations": [
{
"address_1": "3258 Bunker Hill Ln",
"address_purpose": "LOCATION",
"city": "Sparks",
"state": "NV",
"postal_code": "894311150",
"country_code": "US",
"telephone_number": "775-379-0954",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "SHAYNE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-18",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.