NPIMap

Organization Active NPI

William Bee Ririe Hospital

  • Family Nurse Practitioner
  • Crescent Valley, NV
National Provider Identifier
1699284901
Registry record updated Sep 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8857 Issued in NV
Legal business name
WILLIAM BEE RIRIE HOSPITAL
Practice address
5043 Tenabo Avenue
William Bee Ririe Hospital Crescent Valley Clinic
Crescent Valley, NV 89821
Phone
(775) 468-0250
Fax
(775) 468-0255
NPI assigned
Sep 29, 2017
Last updated
Sep 29, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLIAM BEE RIRIE HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2017

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

Authorized official

Name
Mr. Matthew F. WalkerNPI 1568899748
Title
Chief Executive Officer
Phone
(775) 289-3001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8857 NV
Family Nurse Practitioner 363LF0000X 8857 NV Primary
Family Medicine Physician 207Q00000X 8857 NV

Addresses

Primary practice location

5043 Tenabo Avenue
William Bee Ririe Hospital Crescent Valley Clinic
Crescent Valley, NV 89821

Mailing address

1500 Avenue H
Ely, NV 89301
Phone (775) 289-3001

Other names 1

  • William Bee Ririe Hospital Crescent Valley Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000372 NV Part B Supplier - Clinic/Group Practice 9335051747 Receives reassigned benefits from 86 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Crescent Valley, NV; Ely, NV; Eureka, NV

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2133240William Bee Ririe Crescent Valley Clinic5043 Tenabo Avenue, Crescent Valley, NV 89821Certificate of waiverJul 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
WV Ririe Hospital Clini4 organizations share this tax ID, including this one
Part of
WV Ririe Hospital Clini

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506643200000",
    "number": "1699284901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 AVENUE H",
            "city": "ELY",
            "state": "NV",
            "postal_code": "89301",
            "telephone_number": "775-289-3001",
            "fax_number": "775-289-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5043 TENABO AVENUE",
            "address_2": "WILLIAM BEE RIRIE HOSPITAL CRESCENT VALLEY CLINIC",
            "city": "CRESCENT VALLEY",
            "state": "NV",
            "postal_code": "89821",
            "telephone_number": "775-468-0250",
            "fax_number": "775-468-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM BEE RIRIE HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAM BEE RIRIE HOSPITAL",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "775-289-3001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "8857",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "8857",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "8857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "William Bee Ririe Hospital Crescent Valley Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Crescent Valley, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.