Individual provider Active NPI

Marjorie L. Uhalde, PHD, MD

  • Family Medicine Physician
  • Reno, NV
National Provider Identifier
1669568515
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4427 Issued in NV
Practice address
5542 Longley LN
Reno, NV 89511-1886
Phone
(775) 321-1044
Fax
(775) 853-4277
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4427 NV Primary

Addresses

Primary practice location

5542 Longley LN
Reno, NV 89511-1886

Mailing address

5542 Longley LN
Reno, NV 89511-1886
Phone (775) 321-1044

Other practice location 1

7111 S Virginia St
Reno, NV 89511-1115
Phone (775) 851-5700

Other identifiers 1

IdentifierTypeStateIssuer
2016812MedicaidNV

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
I20100222000107 NV Practitioner - Family Practice 7012934086 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sugar Pine Family Medicine P.C., Paul Smith, MD, Et Al Family Medicine CurrentSince Oct 6, 2016 Accepting new patients

Locations

5542 Longley Ln
Reno, NV 89511
Phone (775) 321-1044

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1669568515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5542 LONGLEY LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895111886",
            "telephone_number": "775-321-1044",
            "fax_number": "775-853-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5542 LONGLEY LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895111886",
            "telephone_number": "775-321-1044",
            "fax_number": "775-853-4277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7111 S Virginia St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895111115",
            "country_code": "US",
            "telephone_number": "775-851-5700",
            "fax_number": "775-851-5766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UHALDE",
        "first_name": "MARJORIE",
        "middle_name": "L.",
        "credential": "PHD, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "4427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016812",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.