Active NPI
Deanna Mandichak, P.T.
- Specialist
- Reno, NV
National Provider Identifier
1528149804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0971
- Practice address
- 6548 S McCarran Blvd
Ste a
Reno, NV 89509-6150 - Phone
- (775) 788-5599
- Fax
- (775) 788-5598
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0971 | NV | Primary |
Addresses
Primary practice location
6548 S McCarran Blvd
Ste a
Reno, NV 89509-6150
Mailing address
6548 S McCarran Blvd
Ste a
Reno, NV 89509-6150
Phone (775) 788-5599
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 971 | NV | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carson Physical Therapy, Inc. | Past | Accepting new patients |
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.
-
- Physical Therapy Clinic/Center
- Carson City, NV
- NPI 1528191749
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503360000000",
"number": "1528149804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6548 S MCCARRAN BLVD",
"address_2": "STE A",
"city": "RENO",
"state": "NV",
"postal_code": "895096150",
"telephone_number": "775-788-5599",
"fax_number": "775-788-5598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6548 S MCCARRAN BLVD",
"address_2": "STE A",
"city": "RENO",
"state": "NV",
"postal_code": "895096150",
"telephone_number": "775-788-5599",
"fax_number": "775-788-5598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDICHAK",
"first_name": "DEANNA",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2017-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NV",
"license": "0971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.