Individual provider Active NPI

Alisa Bean, RDN, LD

  • Registered Dietitian
  • Reno, NV
National Provider Identifier
1417547191
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
39883-DI-0 Issued in NV
Practice address
6512 S McCarran Blvd Ste a
Reno, NV 89509-6141
Phone
(775) 788-7600
Fax
(775) 788-7611
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 39883-DI-0 NV Primary

Addresses

Primary practice location

6512 S McCarran Blvd Ste a
Reno, NV 89509-6141

Mailing address

6512 S McCarran Blvd Ste a
Reno, NV 89509-6141
Phone (775) 788-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210224001136 NV Practitioner - Registered Dietitian Or Nutrition Professional 8527473545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39883-DI-0NVMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Urban Indians, Inc. CurrentSince Feb 17, 2021 Accepting new patients
Yacov R Stollman Current Accepting new patients

Locations

236 E Winnie Ln
Carson City, NV 89706
Phone (775) 788-7600

9480 Gateway Dr
Ste 100
Reno, NV 89521
Phone (775) 788-7600

6512 S McCarran Blvd
Ste A
Reno, NV 89509
Phone (775) 788-7600

Organizations & group practices 2

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": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1417547191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6512 S MCCARRAN BLVD STE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096141",
            "telephone_number": "775-788-7600",
            "fax_number": "775-788-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6512 S MCCARRAN BLVD STE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096141",
            "telephone_number": "775-788-7600",
            "fax_number": "775-788-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "ALISA",
        "credential": "RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NV",
            "license": "39883-DI-0",
            "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 Jan 26, 2021; 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.