NPIMap

Organization Active NPI

State of Nevada

  • Case Management Agency
  • Ely, NV
National Provider Identifier
1396984589
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
NA Issued in NV
Legal business name
STATE OF NEVADA
Practice address
1675 Avenue F
Ely, NV 89301-3500
Phone
(775) 289-1671
Fax
(775) 289-1699
NPI assigned
Feb 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Authorized official

Name
Siri McMillin
Title
Billing Supervisor
Phone
(775) 687-7573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NA NV Primary

Addresses

Primary practice location

1675 Avenue F
Ely, NV 89301-3500

Mailing address

4126 Technology Way
Suite 102
Carson City, NV 89706-2066
Phone (775) 687-7573

Other identifiers 1

IdentifierTypeStateIssuer
005417001MedicaidNV

Other names 1

  • ELY MENTAL HEALTH CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nevada State Health Division125 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1396984589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 TECHNOLOGY WAY",
            "address_2": "SUITE 102",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897062066",
            "telephone_number": "775-687-7573",
            "fax_number": "775-687-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 AVENUE F",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893013500",
            "telephone_number": "775-289-1671",
            "fax_number": "775-289-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "MCMILLIN",
        "authorized_official_first_name": "SIRI",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "775-687-7573"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NV",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005417001",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELY MENTAL HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ely, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.