Active NPI
Shane Wakefield
- Physician Assistant
- Sparks, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA3190
- Practice address
- 2375 E Prater Way
Sparks, NV 89434-9641 - Phone
- (775) 331-7000
- Fax
- (775) 352-5303
- NPI assigned
- May 17, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | PA65106 | CA | |
| Physician Assistant | 363A00000X | PA3190 | NV | Primary |
Addresses
Primary practice location
2375 E Prater Way
Sparks, NV 89434-9641
Mailing address
2375 E Prater Way
Sparks, NV 89434-9641
Phone (775) 331-7000
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2375 E Prater Way
Sparks, NV 89434-9641
Phone (775) 351-5301
2385 E Prater Way
Suite 205
Sparks, NV 89434-9688
Phone (775) 356-4888
Hospital & facility affiliations
- Northern Nevada Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA65106 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Nevada Medical Group, LLC | Current | Accepting new patients |
Locations
6500 Longley Ln
Reno, NV 89511
Phone (775) 331-7000
6225 Sharlands Ave
Reno, NV 89523
Phone (775) 356-6662
2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000
2385 E Prater Way
Ste 205
Sparks, NV 89434
Phone (775) 356-4888
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Sparks, NV
- NPI 1972751618
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sparks, NV
- NPI 1548250582
-
- General Acute Care Hospital
- Reno, NV
- NPI 1609451327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784764800000",
"number": "1487345823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2375 E PRATER WAY",
"city": "SPARKS",
"state": "NV",
"postal_code": "894349641",
"telephone_number": "775-331-7000",
"fax_number": "775-352-5303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2375 E PRATER WAY",
"city": "SPARKS",
"state": "NV",
"postal_code": "894349641",
"telephone_number": "775-331-7000",
"fax_number": "775-352-5303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKEFIELD",
"first_name": "SHANE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-17",
"last_updated": "2026-07-23",
"certification_date": "2026-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA65106",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA3190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 23, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.