NPIMap

Organization Active NPI

State of Nevada

  • Case Management Agency
  • Gardnerville, NV
National Provider Identifier
1487832085
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
STATE OF NEVADA
Practice address
1528 US Highway 395 N
Suite 100
Gardnerville, NV 89410-5265
Phone
(775) 782-3671
Fax
(775) 782-6639
NPI assigned
Feb 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Authorized official

Name
Siri McMillin
Title
Billing Supervisor
Phone
(775) 684-5018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

1528 US Highway 395 N
Suite 100
Gardnerville, NV 89410-5265

Mailing address

727 Fairview Dr
Suite a
Carson City, NV 89701-5795
Phone (775) 687-5018

Other identifiers 1

IdentifierTypeStateIssuer
005403001MedicaidNV

Other names 1

  • DOUGLAS MENTAL HEALTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nevada State Health Division125 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1487832085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 FAIRVIEW DR",
            "address_2": "SUITE A",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897015795",
            "telephone_number": "775-687-5018",
            "fax_number": "775-687-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 US HIGHWAY 395 N",
            "address_2": "SUITE 100",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105265",
            "telephone_number": "775-782-3671",
            "fax_number": "775-782-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "MCMILLIN",
        "authorized_official_first_name": "SIRI",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "775-684-5018"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005403001",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOUGLAS MENTAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardnerville, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.