Organization Active NPI

Performance Chiropractic Enterprise LLC

  • Chiropractor
  • Reno, NV
National Provider Identifier
1619054699
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
B01240 Issued in NV
Legal business name
PERFORMANCE CHIROPRACTIC ENTERPRISE LLC
Practice address
5480 Reno Corporate Dr
Suite 200
Reno, NV 89511-2250
Phone
(775) 853-0250
Fax
(775) 853-0252
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Authorized official

Name
Mrs. Trista Dawn Gomez
Title
Office Manager
Phone
(775) 853-0250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X B01240 NV Primary

Addresses

Primary practice location

5480 Reno Corporate Dr
Suite 200
Reno, NV 89511-2250

Mailing address

5480 Reno Corporate Dr
Suite 200
Reno, NV 89511-2250
Phone (775) 853-0250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070110000433 NV Part B Supplier - Clinic/Group Practice 3971503236 Receives reassigned benefits from 1 practitioner
Practice locations: Reno, NV

National Provider Directory

National Provider Directory

Locations

5480 Reno Corporate Dr
#200
Reno, NV 89511
Phone (775) 853-0250

5488 Reno Corporate Dr
Ste 200
Reno, NV 89511
Phone (775) 853-0250

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1619054699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 RENO CORPORATE DR",
            "address_2": "SUITE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112250",
            "telephone_number": "775-853-0250",
            "fax_number": "775-853-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 RENO CORPORATE DR",
            "address_2": "SUITE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112250",
            "telephone_number": "775-853-0250",
            "fax_number": "775-853-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE CHIROPRACTIC ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "TRISTA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "775-853-0250",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B01240",
            "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 Apr 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.