Northern Nevada Medical Group, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NORTHERN NEVADA MEDICAL GROUP, LLC

Practice address

2385 E Prater Way
Suite 300
Sparks, NV 89434-9629

Phone

(775) 356-4888

Fax

(775) 356-4890

NPI assigned

Aug 17, 2012

Last updated

Jun 27, 2019By 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

Todd Evans

Title

Vice-President

Phone

(610) 768-3300

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Uhs of Fairmount Inc

  • Psychiatric Hospital
  • Philadelphia, PA
  • NPI 1215902168

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561593600000",
    "number": "1376891572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S GULPH RD",
            "address_2": "C/O REIMBURSEMENT",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "610-382-4351",
            "fax_number": "775-356-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 E PRATER WAY",
            "address_2": "SUITE 300",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349629",
            "telephone_number": "775-356-4888",
            "fax_number": "775-356-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NEVADA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2019-06-27",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "610-768-3300"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Nevada Adult Mental Health Services
• Northern Nevada Center for Behavioral Services
• Northern Nevada Dental Specialty Group (My Kid's Smile)
• Northern Nevada Family Dental
• Northern Nevada Hearing Aid Center LLC (Miracle Ear)
• Northern Nevada Medical Group, LLC
• Northern Nevada Medical Supply, LLC
• Nova Behavioral Services
• Nova Behavioral Services, LLC
• Violeta Nunez-Calderon

• Durable Medical Equipment & Medical Supplies in Sparks, NV
• Providers in Sparks, NV by specialty
• Durable Medical Equipment & Medical Supplies in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.