Active NPI
Vanessa Willmoth, BCBA
- Behavior Analyst
- Reno, NV
National Provider Identifier
1609368257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA0540
- Practice address
- 75 Pringle Way Ste 300
Reno, NV 89502-8425 - Phone
- (775) 982-3960
- Fax
- (775) 982-3971
- NPI assigned
- May 30, 2018
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | LBA0540 | NV | Primary |
Addresses
Primary practice location
75 Pringle Way Ste 300
Reno, NV 89502-8425
Mailing address
1155 Mill St # McM14
Reno, NV 89502-1576
Phone (775) 982-5262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609368257 | Medicaid | NV |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Regents, Nevada System of Higher Education | Behavior Analyst | 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.
-
- Behavior Analyst
- Reno, NV
- NPI 1063901155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650326400000",
"number": "1609368257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 MILL ST # MCM14",
"city": "RENO",
"state": "NV",
"postal_code": "895021576",
"telephone_number": "775-982-5262",
"fax_number": "775-982-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 PRINGLE WAY STE 300",
"city": "RENO",
"state": "NV",
"postal_code": "895028425",
"telephone_number": "775-982-3960",
"fax_number": "775-982-3971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLMOTH",
"first_name": "VANESSA",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-30",
"last_updated": "2022-04-19",
"certification_date": "2022-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NV",
"license": "LBA0540",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1609368257",
"state": "NV"
}
],
"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 Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.