Marshall W Clyde, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18743 Issued in NV

Practice address

880 Alder Ave FL 2
Incline Village, NV 89451-8335

Phone

(775) 831-6200

NPI assigned

Jun 23, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mclyde1035572@directa.mercy.net

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.

• Tahoe Forest Hospital District

  • Multi-Specialty Clinic/Center
  • Truckee, CA
  • NPI 1750412300
  NPD (past)

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1437445863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 ALDER AVE",
            "city": "INCLINE VILLAGE",
            "state": "NV",
            "postal_code": "894518335",
            "telephone_number": "775-831-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 ALDER AVE FL 2",
            "city": "INCLINE VILLAGE",
            "state": "NV",
            "postal_code": "894518335",
            "telephone_number": "775-831-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "MARSHALL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "18743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Ann Birch, DC
• Rachel Bowdle
• Kelly Elizabeth Brennan, MS, RD, LD
• Elisabeth Helen Brown, BAPPSC, MED
• Christina Harding, MD., PLLC
• Community Health Alliance
• Yvonne Costello
• Monica Anne Courey, MD
• Christopher Delellis, ND
• Lauren Abbey Devalk

• Family Medicine Physician in Incline Village, NV
• Providers in Incline Village, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.