Individual provider Active NPI

Marcus C Mayhall, BS

  • Mental Illness Community Based Residential Treatment Facility
  • Sparks, NV
National Provider Identifier
1467692954
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Practice address
741 Rancho Via Dr
Sparks, NV 89434-4051
Phone
(775) 247-3994
NPI assigned
Feb 24, 2009
Last updated
Feb 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

741 Rancho Via Dr
Sparks, NV 89434-4051

Mailing address

6283 Chesterfield LN
Reno, NV 89523-1726
Phone (775) 247-3994

Other names 1

  • Mr. Marcus C Mayhall Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Etxea Services Community Based Residential Treatment Facility, Mental Illness Past Accepting new patients
Etxea Services LLC Community Based Residential Treatment Facility, Mental Illness Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1467692954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6283 CHESTERFIELD LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895231726",
            "telephone_number": "775-247-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 RANCHO VIA DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894344051",
            "telephone_number": "775-247-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYHALL",
        "first_name": "MARCUS",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCUS",
            "last_name": "MAYHALL",
            "middle_name": "C",
            "prefix": "MR.",
            "credential": "BS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.