NPIMap

Organization Active NPI

South Lyon Health Center, Inc.

Doing business as South Lyon Medical Center

  • Rural Health Clinic/Center
  • Yerington, NV
National Provider Identifier
1649230665
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SOUTH LYON HEALTH CENTER, INC.
Doing business as
South Lyon Medical Center
Practice address
213 S. Whitacre
Yerington, NV 89447-2561
Phone
(775) 463-2301
NPI assigned
Mar 24, 2006
Last updated
May 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Cyli Resendiz
Title
Medical Staff Supervisor
Phone
(775) 463-6462

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 3378RHC-4 NV
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

213 S. Whitacre
Yerington, NV 89447-2561

Mailing address

P.O. Box 940
Yerington, NV 89447-0940
Phone (775) 463-2301

Other identifiers 1

IdentifierTypeStateIssuer
001510010MedicaidNV

Other names 1

  • South Lyon Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031230000357 NV Part B Supplier - Clinic/Group Practice 0648178533 Receives reassigned benefits from 61 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yerington, NV
O20100423000757 NV Part A Provider - Rural Health Clinic 0648178533 Practice locations: Yerington, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649230665. Details of each certification follow.

Rural health clinic certification: CCN 293979

Legal name
SOUTH LYON HEALTH CENTER INC
Doing business as
SOUTH LYON MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 27, 2001
Last certification
Aug 5, 2015
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 7, 1990 in NV
Enrollment address
213 S Whitacre St
Yerington, NV 89447-2561
Related CCNs
290002

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
South Lyon Medical Cent12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Alyce Reese Individual Corporate DirectorDirector Jun 26, 2018
Joanne Lawson Individual Corporate Director Jan 1, 2023
Scott Huntley Individual Corporate Director Jan 1, 2023
Toni a Inserra Individual Corporate OfficerCeo Jan 1, 2014
W-2 Managing EmployeeCeo / Administrator Jul 31, 2013
Emily Christensen Individual Corporate Director Jan 1, 2023

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
South Lyon Medical CenterYerington, NV, CCN 295011 Skilled nursing facility Operational/Managerial Control (100%) Jan 5, 1990

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1649230665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 940",
            "city": "YERINGTON",
            "state": "NV",
            "postal_code": "894470940",
            "telephone_number": "775-463-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S. WHITACRE",
            "city": "YERINGTON",
            "state": "NV",
            "postal_code": "894472561",
            "telephone_number": "775-463-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LYON HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "RESENDIZ",
        "authorized_official_first_name": "CYLI",
        "authorized_official_title_or_position": "MEDICAL STAFF SUPERVISOR",
        "authorized_official_telephone_number": "775-463-6462"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NV",
            "license": "3378RHC-4",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001510010",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Lyon Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Lyon Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yerington, NV

Sources for this page

Verify at the official NPI Registry.