Ilia Yamboliev

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Practice address

1600 Medical Pkwy
Carson City, NV 89703-4625

Phone

(775) 445-8000

Fax

(775) 445-8368

NPI assigned

Jun 28, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1487965182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CENTERVIEW DR",
            "address_2": "SUITE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275274",
            "telephone_number": "615-345-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL PKWY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034625",
            "telephone_number": "775-445-8000",
            "fax_number": "775-445-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMBOLIEV",
        "first_name": "ILIA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall I Wright, DDS
• Ziqiang William Wu, MD
• Jana Wynn
• Noah David Yaeger, APRN, PMHNP-BC
• Richard I Yamamoto, M.D.
• Tiffany L. Yohey, APRN
• Alexis A Young
• Christopher Young
• Frederick T. Young, DMD
• Michelle Loreen Young

• All providers in Carson City, NV
• Electroneurodiagnostic Specialist/Technologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.