Individual provider Active NPI

Richard Duane Runyan Jr., PH.D.

  • Clinical Psychologist
  • Carson City, NV
National Provider Identifier
1497809651
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0386 Issued in NV
Practice address
1001 Mountain St Ste 3H
Carson City, NV 89703-3812
Phone
(775) 445-7756
Fax
(775) 841-0304
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0386 NV Primary

Addresses

Primary practice location

1001 Mountain St Ste 3H
Carson City, NV 89703-3812

Mailing address

1001 Mountain St Ste 3H
Carson City, NV 89703-3812
Phone (775) 445-7756

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY0386NVMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497809651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MOUNTAIN ST STE 3H",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897033812",
            "telephone_number": "775-445-7756",
            "fax_number": "775-841-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MOUNTAIN ST STE 3H",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897033812",
            "telephone_number": "775-445-7756",
            "fax_number": "775-841-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNYAN",
        "first_name": "RICHARD",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.