Individual provider Active NPI

Mary F Wellhoner, M.D.

  • Gynecology Physician
  • Reno, NV
National Provider Identifier
1467561597
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
8741 Issued in NV
Practice address
645 Sierra Rose Dr
Suite 204
Reno, NV 89511-2060
Phone
(775) 352-9355
Fax
(775) 352-3575
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 8741 NV Primary

Addresses

Primary practice location

645 Sierra Rose Dr
Suite 204
Reno, NV 89511-2060

Mailing address

645 Sierra Rose Dr
Suite 204
Reno, NV 89511-2060
Phone (775) 352-9355

Other identifiers 1

IdentifierTypeStateIssuer
002016598MedicaidNV

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050909000912 NV Practitioner - Obstetrics/Gynecology 9133151178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of California, San Diego School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elizabeth a. Hutson M.D. LTDGroup PAC ID 8123107935, 8 clinicians

Practice addresses (Care Compare)

1441 Pullman Dr
Sparks, NV 89434-7921
Phone (775) 432-1343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8741NVMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth a. Hutson M.D. LTD Gynecology CurrentSince Jan 1, 2024 Accepting new patients
Bruce Scott Crawford MD LTD Gynecology Past Accepting new patients

Locations

1441 Pullman Dr
Sparks, NV 89434
Phone (775) 351-2600

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1467561597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 SIERRA ROSE DR",
            "address_2": "SUITE 204",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112060",
            "telephone_number": "775-352-9355",
            "fax_number": "775-352-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 SIERRA ROSE DR",
            "address_2": "SUITE 204",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112060",
            "telephone_number": "775-352-9355",
            "fax_number": "775-352-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLHONER",
        "first_name": "MARY",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NV",
            "license": "8741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002016598",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.