Clark W Pillsbury, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

8801 Issued in NV

Practice address

10463 Double R Blvd
Suite 100
Reno, NV 89521-8908

Phone

(775) 358-2542

Fax

(775) 358-1413

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sierra Vista Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Reno, NV
  • NPI 1912011297
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1467526509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10463 DOUBLE R BLVD",
            "address_2": "SUITE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218908",
            "telephone_number": "775-358-2542",
            "fax_number": "775-358-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10463 DOUBLE R BLVD",
            "address_2": "SUITE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218908",
            "telephone_number": "775-358-2542",
            "fax_number": "775-358-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLSBURY",
        "first_name": "CLARK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "8801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00036112",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002116004",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Pike
• Teresa Pilcher
• Carl Pilgrim
• Roshan Ravi Pillai, DO
• Anjani Pillarisetty
• Jyothy Pilly, MD
• Cindy Pimentel
• Ana Pina
• Pinecone Physio PLLC
• Rachel Michelle Pink, APRN

• Podiatrist in Reno, NV
• Providers in Reno, NV by specialty
• Podiatrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.