Individual provider Active NPI

Justin John Sonderegger, MD

  • Emergency Medicine Physician
  • Reno, NV
National Provider Identifier
1588890693
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14275 Issued in NV
Practice address
832 Willow St
Reno, NV 89502-1304
Phone
(775) 324-4040
Fax
(775) 324-4042
NPI assigned
Jun 3, 2009
Last updated
Jul 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301094467 MI
Emergency Medicine Physician 207P00000X 4301094467 MI
Emergency Medicine Physician 207P00000X 14275 NV Primary

Addresses

Primary practice location

832 Willow St
Reno, NV 89502-1304

Mailing address

832 Willow St
Reno, NV 89502-1304
Phone (775) 324-4040

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120620000455 NV Practitioner - Emergency Medicine 1456518943 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301094467MIMDEmergency Medicine Physician
14275NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brown, Calvanese, Cameron LTD Emergency Medicine CurrentSince Jul 17, 2012 Accepting new patients

Locations

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

832 Willow St
Reno, NV 89502
Phone (775) 324-4040

2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1588890693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 WILLOW ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021304",
            "telephone_number": "775-324-4040",
            "fax_number": "775-324-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 WILLOW ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021304",
            "telephone_number": "775-324-4040",
            "fax_number": "775-324-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONDEREGGER",
        "first_name": "JUSTIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301094467",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301094467",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "14275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.